PMC5753927_01
Clinical images of the ocular surface of the (a,d) right and (b,c,e) left eyes of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome in both eyes on (a,b) days 11, (c) 35 and (d,e) 63 after initial presentation
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However, there were numerous punctate areas of fluorescein retention in the interpalpebral cornea OS, and an ill-defined area of stippled fluorescein retention in the dorsal cornea OU (Figure 1a,b). Re-examination on day 35 revealed resolution of the corneal ulcer OS with resultant focal fibrosis (Figure 1c).
Time course describing lacrimostimulant and lacrimomimetic therapy, as well as Schirmer tear test-1 (STT-1) values for the right eye (dark gray) and left eye (light gray) of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome in both eyes. The horizontal dashed line represents the minimum STT-1 value considered normal in cats (9 mm/min). Day number is relative to initial presentation
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Figure 2 shows the lacrimostimulant and lacrimomimetic therapies used, as well as STT-1 values over the ensuing 81 days.
Confocal photomicrographs of the cornea of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome in both eyes. Note the (a) thin, disorganized epithelium with few hyper-reflective epithelial cells and leukocytes scattered within superficial to intermediate epithelial layers; (b) diminished to regionally absent sub-basal nerve plexus; (c) normal oval-shaped and elongated nuclei of keratocytes in the mid corneal stroma; and (d) normal corneal endothelial morphology and cell density (2400 cells/mm2; reference value 2520 cells/mm2). Bar = 50 microm
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Corneal confocal microscopy performed immediately post-mortem using full-thickness scans set at 3 mum increments (Confoscan 4; Nidek) revealed attenuated and disorganized corneal epithelium and a diminished to regionally absent sub-basal nerve plexus but normal corneal stroma and endothelium OU (Figure 3).
Photomicrographs of the cornea (a) OD and (b) OS of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome OU. Both corneas had mild neutrophilic inflammation (black arrowhead), neovascularization (white arrow), anterior stromal fibrosis (asterisk), epithelial attenuation with segmental erosion and detachment (black arrow). Bar = 200 microm for gross images and 50 microm for insets
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Histologic examination revealed that both corneas had mild neutrophilic inflammation, neovascularization, anterior stromal fibrosis, epithelial attenuation with segmental erosion and detachment (Figure 4).
Photomicrographs of the third eyelid OS of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome OU. Sections were stained using the periodic acid-Schiff technique and goblet cells are stained magenta. Relative to published reference intervals, conjunctival goblet cell density is markedly decreased on the (a, arrow) anterior and (b, arrowhead) posterior surfaces of the third eyelid. Bar = 100 microm
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Conjunctival goblet cell density (GCD) was 0% on the anterior and 3% on the posterior surfaces (Figure 5) of the third eyelid; mean reference values for these locations are 48.8% and 12.6%, respectively.
Photomicrographs of the (a) orbital lacrimal gland OD and (b) third eyelid gland OS of a 14-year-old female spayed Abyssinian cat with neurogenic dry eye syndrome OU. Note the (a) small aggregates of lymphocytes (arrow) around lacrimal lobules embedded in adipose tissue OD; and (b) mild-to-moderate numbers of perivascular lymphocytes and plasma cells (arrowhead) in the lamina propria of the third eyelid gland OS. Bar = 100 microm for (a) and 200 microm for (b)
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Small numbers of lymphocytes and plasma cells were scattered around individual tubuloalveolar structures in the orbital lacrimal and third eyelid glands OU (Figure 6).