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Freepdf XP File Tierärztliche Hochschule Hannover Tonometrie und Evaluierung zweier Tränentests bei Bartagamen (Pogona spp.) INAUGURAL – DISSERTATION- zur Erlangung des Grades einer Doktorin der Veterinärmedizin - Doctor medicinae veterinariae - ( Dr. med. vet. ) vorgelegt von Eva Julia Schuster Würzburg Hannover 2014 Wissenschaftliche Betreuung: Univ. - Prof. Dr. med. vet. M. Fehr Klinik für Heimtiere, Reptilien, Zier- und Wildvögel 1. Gutachter: Univ.- Prof. Dr. med. vet. M. Fehr 2. Gutachter: Univ.- Prof. Dr. med. vet. W. Meyer Tag der mündlichen Prüfung: 05.05.2014 Meiner Familie, mit Dank für alles! Teile dieser Arbeit wurden bei der folgenden Zeitschrift zur Veröffentlichung eingereicht: • Journal of Small Animal Practice (eingereicht am 03.04.2014; im Review) Intraocular pressure measurement in clinically healthy Inland bearded Dragons (Pogona vitticeps) Eva J. Schuster D.V.M., Julia Strüve D.V.M. , Michael Fehr Dipl. ECZM (Small mammals), Karina A. Mathes Dipl. ECZM (Herpetology) Ergebnisse dieser Dissertation wurden auf folgenden Fachtagungen präsentiert: • 41. Arbeitstagung der DGHT AG ARK „Schwerpunktthema Neurologie“ (Mai 2014)- Vortrag Augeninnendruckmessung bei Bartagamen ( Pogona spp. ) E. Schuster, M. Fehr, K. Mathes, J. Strüve • 1. Jahrestagung der DVG-Fachgruppe Zier-, Zoo- und Wildvögel, Reptilien und Amphibien (März 2014)- Posterpräsentation Versuch der Kalibrierung des Rebound-Tonometers Tonovet ® bei Bartagamen ( Pogona spp.) E. Schuster, J. Strüve, M. Fehr, K. Mathes Inhaltsverzeichnis Inhaltsverzeichnis 1. Einleitung ..............................................................................................................1 2. Literaturübersicht .................................................................................................2 2.1 Augenerkrankungen bei Reptilien ................................................................2 2.2. Anatomie relevanter Strukturen des Reptilienauges ..................................5 2.2.1 Allgemeines ...................................................................................................5 2.2.2 Knöcherne Augenhöhle ( Orbita ) und Anhänge ( Adnexe ) ............................. 6 2.2.3 Tränenapparat ( Apparatus lacrimalis ) ........................................................... 8 2.2.4 Augapfel ( Bulbus oculi ) und Lederhaut ( Sklera ) ........................................ 10 2.2.4.1 Hornhaut ( Cornea ) ................................................................................... 10 2.2.4.2 Vordere Augenkammer ( Camera anterior bulbi ) und mittlere Augenhaut (Uvea ) .................................................................................................................. 11 2.2.4.3 Linse (Lens oculi) ..................................................................................... 13 2.2.4.4 Hintere Augenkammer ( Camera posterior bulbi ) und Netzhaut ( Retina ) .14 2.2.5 Sehvermögen ............................................................................................ 15 2.3. Augenuntersuchung bei Reptilien ............................................................. 16 2.4 Augeninnendruck ........................................................................................ 19 2.4.1 Produktion und Verteilung des Kammerwassers ......................................... 19 2.4.2 Regulierung des Augeninnendrucks ............................................................20 2.4.3 Pathologie des Augeninnendrucks und klinische Relevanz bei Reptilien ...21 2.4.4 Potentielle Einflussfaktoren auf den Augeninnendruck in der Klinik ........... 22 2.4.4.1 Alter .........................................................................................................22 2.4.4.2 Geschlecht/ Reproduktionsstatus ............................................................22 2.4.4.3 Tageszeit .................................................................................................23 2.4.4.4 Gewicht und Körpergröße (Schnauzen- Schwanz- Länge) .....................23 2.4.4.5 Umgebungstemperatur und Jahreszeit (Hibernation) .............................24 2.4.4.6 Anästhesie/ Lokalanästhesie (LA) .......................................................... 24 2.4.4.7 Körperhaltung/ Fixation ............................................................................ 25 2.4.4.8 Sonstige Faktoren .................................................................................... 25 Inhaltsverzeichnis 2.5. Messverfahren zur Erhebung des Augeninnendrucks ............................. 25 2.5.1 Manometrie .................................................................................................. 26 2.5.2 Tonometrie .................................................................................................. 26 2.5.2.1 Messwertbeeinflussung durch Hornhauteigenschaften ............................ 28 2.5.2.2 Weitere Fehlerquellen ............................................................................... 29 2.6 Tränenfilm ..................................................................................................... 30 2.6.1. Tränenzusammensetzung und Besonderheiten bei Reptilien ..................... 30 2.6.2 Pathophysiologie der Tränenproduktion und Symptomatik ......................... 31 2.6.3. Erkrankungen des Tränenapparates bei Reptilien ...................................... 31 2.7. Messung der Tränenproduktion ................................................................. 32 2.7.1.Schirmer- Tränen- Test (STT I) ................................................................... 32 2.7.2 Phenolrot- Test (PRT) ................................................................................. 32 2.7.3 Papierspitzen (endodontic absorbent paper points- EAPP) ........................ 33 3. Material und Methoden ....................................................................................... 34 3.1 Zielsetzung ................................................................................................... 35 3.2. Klinische Versuche ...................................................................................... 35 3.2.1 Patientengut und Tierdaten ......................................................................... 35 3.2.2 Feststellung der Klinischen Gesundheit ....................................................... 36 3.2.3 Ophthalmologische Untersuchung ............................................................... 37 3.2.4 Tonometrieversuch ...................................................................................... 39 3.2.4.1 Unterbringung der Tiere ............................................................................ 40 3.2.4.2 Zeitlicher Ablauf der Messungen im Tonometrieversuch .......................... 41 3.2.4.3 Messung mit dem TonoVet® .................................................................... 41 3.2.4.4 Messung mit dem TonoPen® ................................................................... 43 3.2.4.5 Messsequenzen ........................................................................................ 45 3.2.4.5.1 Diurnale Messungen innerhalb der POTZ ............................................. 45 3.2.4.5.2 Messungen unter Lokalanästhetikum (TonoVet®) ................................. 46 3.2.4.5.3 Messungen unter Temperaturabfall ....................................................... 46 3.2.5. Evaluierung der Tränenproduktion.............................................................. 47 3.2.5.1 Tränenproduktionsmessung mit dem Phenolrot- Test (PRT) ................... 48 Inhaltsverzeichnis 3.2.5.2 Tränenproduktionsmessung mit Endodontic Absorbent Paper Points (EAPP) .................................................................................................................. 49 3.2.5.3 Ergänzende Parameter ............................................................................. 51 3.2.6 Kalibrierung des TonoVet® (Manometrie) .................................................. 52 3.2.6.1 Versuchsmaterial ...................................................................................... 53 3.2.6.2 Versuchsdurchführung .............................................................................. 54 3.2.7 Statistische Auswertung .............................................................................. 56 3.2.7.1 Klinischer Versuch (Tonometrie) .............................................................. 57 3.2.7.2 Messung der Tränenproduktion ................................................................ 57 3.2.7.3 Ergänzende Parameter ............................................................................. 57 3.2.7.4 Manometrie (Kalibrierung des TonoVet®) ................................................ 57 3.3 Genehmigung der Tierversuche .................................................................. 58 4. Ergebnisse .......................................................................................................... 59 4.1 Klinische Allgemeingesundheit, Labor- und Röntgenuntersuchungen .. 59 4.2 Augenuntersuchung ..................................................................................... 60 4.3 Messungen mit dem TonoVet® ................................................................... 63 4.4 Messungen mit dem TonoPen® .................................................................. 63 4.5. Messsequenzen Tonometrie ....................................................................... 64 4.5.1 Diurnale Messungen ...................................................................................
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