Felis ISSN 2398-2950

Cornea: eosinophilic/proliferative keratoconjunctivitis

Contributor(s): Dennis E Brooks, David Williams, Natasha Mitchell

Introduction

  • Corneal neovascularization associated with superficial white corneal plaques and ocular discharge.
  • May be confined to the conjunctiva (termed eosinophilic conjunctivitis)  →  thickening with a scant, adherent surface discharge.
  • Cause: unknown, although feline herpesvirus has been isolated from a high proportion (but not all) of lesions.
  • Signs: superficial vascularization of the cornea associated with superficial white corneal plaques and a white floccular discharge.
  • Diagnosis: clinical presentation, physical examination and conjunctival scrapes   →   cytology.
  • Treatment: usually controllable with topical corticosteroids and/or cyclosporine; also responds well to megestrol acetate medication.
    Megestrol acetate may have serious systemic side-effects (so if choosing to use this medication only employ for very limited period).

Pathogenesis

Pathophysiology

  • Cats usually healthy, has minimal affect on well-being.
  • Cause usually unknown - it suspected to be caused by an immune mediated response to an unknown antigenic stimulus.
  • Herpes virus Viral-induced upper respiratory tract disease has been found in corneal samples of many (but not all) affected animals, but there is no proven association. It could be that both the corneal inflammation and the stress associated with the condition could be responsible for recrudescent FHV-1 disease in latently affected cats.
  • Cases of suspected hypersensitivity have reportedly been seen associated with the condition (uncommonly).

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Villatoro A J, Claros S, Fern√°ndez V et al (2018) Safety and efficacy of the mesenchymal stem cell in feline eosinophilic keratitis in cats. BMC Veterinary Research 14 (1), 116 PubMed.
  • Stiles J & Coster M (2016) Use of an ophthalmic formulation of megestrol acetate for the treatment of eosinophilic keratitis in cats. Vet Ophthalmol 19 (Suppl 1), 86-90 PubMed.
  • Dean E, Meunier V (2013) Feline eosinophilic keratoconjunctivitis: a retrospective study of 45 cases (56 eyes). J Feline Med Surg 15 (8), 661-666 PubMed.
  • Bedford P (1997) What is your diagnosis? Eosinophilic keratoconjunctivitis. JSAP 38 (6), 233, 270 PubMed.
  • Morgan R V, Abrams K L & Kern T J (1996) Feline eosinophilic keratitis: a retrospective study of 54 cases: (1989-1994). Vet and Comp Ophthalmology (2), 131-4 VetMedResource.
  • Prasse K W & Winston S M (1996) Cytology and histopathology of feline eosinophilic keratitis. Vet and Comp Ophthalmology (2), 74-81 VetMedResource.

Other sources of information

  • Nasisse M P (1991) Feline Ophthalmology. In:Vet Ophthal, 2nd edition. Ed: Gelatt K N. p529. Lea and Febiger, Philadelphia.
  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology.2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4


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