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Redalyc.Uveitis in Dogs Infected with Ehrlichia Canis

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Redalyc.Uveitis in Dogs Infected with Ehrlichia Canis Ciência Rural ISSN: 0103-8478 [email protected] Universidade Federal de Santa Maria Brasil Pontes Oriá, Arianne; Mendes Pereira, Patrícia; Laus, José Luiz Uveitis in dogs infected with Ehrlichia canis Ciência Rural, vol. 34, núm. 4, julho-agosto, 2004, pp. 1289-1295 Universidade Federal de Santa Maria Santa Maria, Brasil Disponível em: http://www.redalyc.org/articulo.oa?id=33134455 Como citar este artigo Número completo Sistema de Informação Científica Mais artigos Rede de Revistas Científicas da América Latina, Caribe , Espanha e Portugal Home da revista no Redalyc Projeto acadêmico sem fins lucrativos desenvolvido no âmbito da iniciativa Acesso Aberto Ciência Rural, Santa Maria, v.34, n.4, p.1289-1295,Uveitis jul-ago, in dogs 2004 infected with Ehrlichia canis. 1289 ISSN 0103-8478 Uveitis in dogs infected with Ehrlichia canis Uveíte em cães infectados com Ehrlichia canis Arianne Pontes Oriá1 Patrícia Mendes Pereira1 José Luiz Laus2 - REVISÃO BIBLIOGRÁFICA - RESUMO ANATOMY AND PHYSIOLOGY OF THE UVEAL TRACT As uveítes, que se constituem em oftalmopatias comuns entre os cães, decorrem de inúmeras causas. Em nosso meio, destaca-se a erliquiose. Este artigo discute as várias causas Uveitis refers to the inflammation of the da enfermidade ocular, bem como aspectos importantes da uveal tract, which is the vascular and pigmented coat enfermidade parasitária, incluindo os sinais, o diagnóstico e o of the eye (HAKANSON & FORRESTER, 1990). The tratamento. uveal tract or uvea is deeply located on the sclera, Palavras-chave: canino, corioretinite, hifema, uveíte, Ehrlichia where it attaches itself. It consists of three zones: canis. choroid, ciliary body and iris (HAKANSON & FORRESTER, 1990). The iris controls the intensity ABSTRACT of the light that penetrates to the posterior segment of Uveitis is a common disease in dogs with a multitude the eye. The ciliary body promotes visual of causes, one of them being ehrlichiosis. This article reviews accommodation, the production of the aqueous humor, several uveitis etiologies, as well as the important aspects of and has an important role in the regulation of canine ehrlichiosis, including its diagnosis and the main ophthalmic signs presented in these cases. It also reports the intraocular pressure (IOP) (COLLINS & MOORE, therapy that should be used. 1999). Visual accommodation is accomplished Key words: canine, chorioretinitis, hyphema, uveitis, Ehrlichia using the ciliary body muscles. In uveitis, these muscle canis. spasm cause intense pain to the animal (HAKANSON & FORRESTER, 1990). The aqueous humor helps INTRODUCTION maintain intraocular pressure, which can be affected by circadian variations, contraction of the extraocular In this review article, we describe the muscles, intraocular inflammation, changes to osmotic anatomy and physiology of the uveal tract, the clinical and blood pressures (under the influence of median signs and pathophysiological mechanisms of uveitis, arterial pressure and central venous pressure) and by the diseases known to cause uveitis in dogs, the history topical and systemic drugs, among other factors and pathogenesis of ehrlichiosis, the clinical signs and (SLATTER, 1990). Inflammation of the anterior uvea diagnosis of ehrlichiosis and the treatment for leads to a reduction in the active secretion of the ehrlichiosis and uveitis. aqueous humor, lowering intraocular pressure (COOK 1Graduate Students, Veterinary College, São Paulo State University (UNESP), Jaboticabal, SP, Brazil. 2Professor, DVM, PhD, Veterinary College, UNESP, Jaboticabal, Via de Acesso Prof. Paulo Donato Castellane s/n, 14884-900, Jaboticabal, SP, Brazil. E.mail: [email protected]. Tel: 55 16 32092626 – Fax: 55 16 32024275. Autor para correspondência. Recebido para publicação 29.05.03 Aprovado em 29.10.03Ciência Rural, v. 34, n.4, jul-ago, 2004. 1290 Oriá et al. & PEIFFER, 1997). The obstruction of the trabecular The healing process in these spots results in areas of meshwork by inflammatory debris can delay or hyperreflectivity and pigment deposition on the tapetal obstruct its drainage, increasing the intraocular and non-tapetal regions, respectively (HAKANSON pressure (BANKS, 1992). & FORRESTER, 1990; POWELL, 2002). The anterior uvea is the site of the blood- The pathophysiological mechanisms in aqueous barrier, which prevents the access of proteins which systemic infections can lead to uveitis are the and blood cells into intraocular fluid (HAKANSON direct destruction of the uveal tissues by infectious & FORRESTER, 1990). Changes in these functions agents or the presence of immune-mediated events may result in the reduction or loss of vision. Therefore, associated with infectious agents, including all four changes in the anterior uvea are of great clinical of the classical hypersensitivity responses (I, II, III, significance (COLLINS & MOORE, 1999). The and IV) (FISCHER & EVANS, 2002). Many choroid or posterior uvea is the most important endogenous causes of uveitis have been recognized vascular portion of the eye and is the largest nutrition as bacterial (Brucella canis, Borrelia burgdorferi), source for the dog’s retina and also has a fundamental fungal (Blastomyces dermatitidis, Cryptococcus importance to heat dissipation, which is created by neoformans, Histoplasma capsulatum), parasitic light reactions (BISTNER, 1996). (Dirofilaria immitis, Diptera spp. (fly larvae), ocular It is worth noting that the uvea has a highly larva migrans (Toxocara and Baylisascaris spp.), inflammatory reaction in dogs (HAKANSON & protozoan (Leishmania donovani, Toxoplasma FORRSTER, 1990). During the inflammatory process, gondii), rickettsial (Ehrlichia canis or Ehrlichia capillary permeability is increased, causing cells and platys, Rickettsia rickettsii), viral (adenovirus, proteins to migrate to the aqueous humor and vitreous, herpesvirus, distemper), idiopathic (trauma, toxemia, resulting in an increased inflammatory response and corneal ulceration), neoplastic and paraneoplastic the deposition of antigen-antibody complexes disorders (hyperviscosity syndrome, primary and (HAKANSON & FORRESTER, 1990). secondary neoplasia, granulomatous meningoencephalitis), metabolic disorders (phacolytic UVEITIS uveitis – diabetic cataract), coagulopathy and immune- mediated disorders (vasculitis, cataract - lens induced Uveitis is described as a group of diseases or phacolytic uveitis, lens trauma – phacoclastic uveitis of endogenous or exogenous origin (BISTNER et al., and uveodermatologic syndrome) (POWELL, 2002). 1996). It is a complex inflammatory process clinically characterized by alterations to vascular permeability EHRLICHIOSIS – HISTORY AND PATHOGENESIS and cell infiltration (POWELL, 2002). It is not a simple nosologic entity and therefore should be treated as an Due to its severity, the ehrlichiosis is ocular manifestation of different systemic diseases. considered one of the most potentially fatal disease in Uveitis should be differentiated from other ocular domestic and wild dogs (PYLE, 1980). Ehrlichia afflictions that also cause pain and hyperemia. One canis belongs to the Rickettsiaceae family, which is a should be attentive and thorough when distinguishing small, gram-negative coccoid bacterium that between various types and causes of uveitis parasitizes circulating monocytes intracytoplasmically (HAKANSON & FORRESTER, 1990). in clusters called morulae (HARRUS et al., 1997; Uveitis can be classified into anterior uveitis WANER et al., 1999). The disease is transmitted by (iridocyclitis), posterior uveitis (choroiditis) and the tick Rhipicephalus sanguineus (MARTIN, 1999). panuveitis (COLLINS & MOORE, 1999; POWELL, The disease was first identified as a specific 2002). entity in Algeria in 1935. Since then, it has been Some of the clinical signs of anterior uveitis recognized worldwide (HARRUS et al., 1997). In are conjunctival hyperemia, ciliary flush, corneal Brazil, canine ehrlichiosis was first diagnosed by edema, presence of keratic precipitates, miosis, flare, COSTA in Belo Horizonte in 1973, and later in rubeosis iridis, iris color change, hyphema, anterior Curitiba by KAVINSKI in 1988. and posterior synechiae, cataract and reduction of the The pathogenesis of ehrlichiosis begins intraocular pressure. Acute posterior uveitis can be with an incubation period of 8 to 20 days; which is observed as hyporeflective lesions on the tapetal followed by acute, subclinical and chronic phase of fundus, which can lead to retinal detachment. In the the disease (HARRUS et al., 1997; NEER, 1998). non-tapetal fundus, alterations can be seen as whitish- During the acute phase, the parasite enters the grayish spots (HAKANSON & FORRESTER, 1990). bloodstream and the lymphatic system and stays in Ciência Rural, v. 34, n.4, jul-ago, 2004. Uveitis in dogs infected with Ehrlichia canis. 1291 mononuclear phagocyte cells of the spleen, liver and lesions have been present during the acute states, with lymph nodes, where it will replicate (HARRUS et al., 50% of the inoculated dogs developing ocular lesions 1997). These cells spread the rickettsias to other organs (MARTIN, 1999). The prevalence of ocular lesions that interact with endothelial cells to induce a vasculitis in naturally occurring cases ranges from 10% to 15% (HARRUS et al., 1997). (MARTIN, 1999). The ocular findings include Evidence that immunogenic mechanisms conjunctival hemorrhages, episcleral congestion, play a role in the pathogenesis of ehrlichiosis includes anterior chamber flare, rubeosis iridis, miosis, corneal histological findings
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