Pool House Equine Hospital, IVC Evidensia, Staffordshire, UK.
Little Rock Equine Vets, Staffordshire, UK.
Vet Med Sci. 2024 May;10(3):e1471. doi: 10.1002/vms3.1471.
A 15-month-old, grey, Thoroughbred filly presented for investigation of a 6-week history of corneal oedema and blepharospasm on the right eye (OD). The filly was otherwise healthy. Following ophthalmic examination, glaucoma on the OD was diagnosed. A space occupying mass within the anterior chamber was documented on transpalpebral ultrasonographic examination. This mass obliterated most of the anterior intraocular structures on the peripheral nasal side (corneal endothelium and drainage angle), leading to secondary glaucoma. After systemic and topical treatment addressing secondary glaucoma, the corneal oedema reduced. The mass was visualised as an irregularly rounded brown structure associated with the iris on the peripheral nasal side of the anterior chamber. Given the filly's signalment, location and appearance of the mass, a tentative diagnosis of intraocular melanoma was made and enucleation was performed. Histopathological evaluation of the globe revealed solid sheets of heavily pigmented melanocytic cells, disrupting the normal ciliary body architecture and extending into the iris and subretinal. The cells were pleomorphic, polyhedral to round with occasional spindle-shaped cells, and contained moderate to large amounts of granular black-brown pigment (melanin). The iridal component expanded into the anterior chamber, with cells directly opposed to Descemet's membrane, with loss of the endothelium and expanding and occluding the filtration angle in this area. The lesion infiltrated locally into the edge of the sclera, but did not extend through the sclera, though occasional perivascular clusters of melanophages were observed within the scleral stroma adjacent to the optic nerve. Diagnosis of a uveal melanocytic neoplasm was confirmed, with characteristics similar to only one reported case . This is a unique case of a rapidly growing, invasive, uveal melanoma in a young horse. Intraocular melanoma should be considered as a differential diagnoses for glaucoma in grey horses, regardless of the age and absence of melanocytic skin lesions.
一只 15 个月大的灰色纯血马母驹,因右眼(OD)角膜水肿和眼睑痉挛的 6 周病史就诊。该驹其他方面健康。经过眼科检查,诊断为 OD 青光眼。经经眶超声检查发现前房内有占位性病变。该病变使大部分前房内结构在周边鼻侧(角膜内皮和房水引流角)被遮挡,导致继发性青光眼。在进行治疗继发性青光眼的全身和局部治疗后,角膜水肿减轻。该病变在周边鼻侧前房内表现为与虹膜相连的不规则圆形棕色结构。考虑到该驹的特征、病变的位置和外观,初步诊断为眼内黑色素瘤,并进行了眼球摘除术。眼球的组织病理学评估显示,大量密集的黑色素细胞呈实性片状,破坏了正常的睫状体结构,并延伸到虹膜和视网膜下。细胞形态多样,多为多角形至圆形,偶尔有梭形细胞,含有中等至大量的颗粒状黑棕色色素(黑色素)。虹膜成分扩展到前房,细胞直接与角膜内皮接触,导致内皮细胞丧失,并在该区域扩张和阻塞房水引流角。病变局部浸润到巩膜边缘,但未穿过巩膜,尽管在视神经旁的巩膜基质中偶尔观察到血管周围黑色素细胞簇。诊断为葡萄膜黑色素瘤,具有与仅报道过的一例病例相似的特征。这是一例年轻马中快速生长、侵袭性的葡萄膜黑色素瘤的独特病例。无论年龄大小和是否存在黑色素细胞皮肤病变,对于灰色马的青光眼,都应考虑眼内黑色素瘤作为鉴别诊断。