Veterinary Ophthalmology Quiz
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Questions and Answers

What is the limitation of a study that suggests a causal relationship between nKCS and medication application in dogs?

  • The study only included dogs with previous ophthalmic signs
  • The study was prospective in nature
  • The study did not use a control group
  • The sample size was small and the data was retrospective (correct)

    • What is the primary mechanism of action of pilocarpine in treating canine neurogenic keratoconjunctivitis sicca?

  • Inhibition of parasympathetic denervation
  • Induction of hypothyroidism
  • Activation of otic nerve pathways
  • Stimulation of lacrimal gland postganglionic innervation (correct)

    • What is the suspected cause of neurogenic keratoconjunctivitis sicca in dogs?

  • Application of otic medications containing terbinafine and florfenicol (correct)
  • Poor diet and nutrition
  • Viral infections
  • Genetic predisposition

    • Which of the following is a potential complication of otic medication use in dogs?

    <p>Ototoxicity</p> Signup and view all the answers

    What is the primary objective of the study?

    <p>To investigate the correlation between otic medications and neurogenic keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the potential complication of using otic medications in dogs?

    <p>Ototoxicity</p> Signup and view all the answers

    What is the name of the condition characterized by reduced tear production in dogs, often associated with endocrinopathies?

    <p>Neurogenic keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the name of the statistical method used to control the false discovery rate in multiple testing?

    <p>Benjamin-Hochberg method</p> Signup and view all the answers

    What is the diagnostic criterion used to confirm neurogenic keratoconjunctivitis sicca in the study?

    <p>Low Schirmer tear test value (&lt; 15 mm/min)</p> Signup and view all the answers

    What is the term for the association of otitis media with chronic otitis externa in dogs?

    <p>Occult otitis media</p> Signup and view all the answers

    How many client-owned dogs were included in the study?

    <p>29</p> Signup and view all the answers

    Which of the following is a common symptom of canine neurogenic keratoconjunctivitis sicca?

    <p>Corneal ulcers</p> Signup and view all the answers

    What is the timeframe for the onset of clinical signs of neurogenic keratoconjunctivitis sicca in dogs after application of otic medications?

    <p>Within 1 day</p> Signup and view all the answers

    What is the application of nonhypotensive autonomic agents in veterinary ophthalmology?

    <p>Treatment of tear deficiency</p> Signup and view all the answers

    What is the term for the study of the diagnosis and treatment of disorders of the eye?

    <p>Ophthalmology</p> Signup and view all the answers

    What is the name of the medication combinations suspected to cause neurogenic keratoconjunctivitis sicca in dogs?

    <p>Claro and Neptra</p> Signup and view all the answers

    What is the neurological manifestation of ear disease in dogs?

    <p>Vestibular signs</p> Signup and view all the answers

    Which of the following is a potential cause of canine neurogenic keratoconjunctivitis sicca?

    <p>Parasympathetic denervation</p> Signup and view all the answers

    What is the term used to describe the dryness of the eyes in dogs?

    <p>Keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the purpose of using magnetic resonance imaging (MRI) in dogs with chronic otitis externa?

    <p>To diagnose otitis media</p> Signup and view all the answers

    What is the name of the medical condition characterized by a deficiency in tear production in dogs?

    <p>Keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the regulatory agency responsible for overseeing the use of otic medications in dogs?

    <p>Food and Drug Administration (FDA)</p> Signup and view all the answers

    What is the primary mechanism by which otic medications are thought to cause neurogenic keratoconjunctivitis sicca in dogs?

    <p>Neurological damage to the tear production pathways</p> Signup and view all the answers

    Which of the following is a potential complication of canine neurogenic keratoconjunctivitis sicca?

    <p>Corneal ulcers</p> Signup and view all the answers

    What is the primary site of lesions that result in postganglionic innervation defects leading to nKCS in dogs?

    <p>Total ear canal ablation and bulla osteotomy</p> Signup and view all the answers

    Which nerves are affected in dogs with unilateral, severe ocular discomfort and a Schirmer tear test (STT) value of close to zero?

    <p>Deep petrosal nerve</p> Signup and view all the answers

    What is the common ocular symptom observed in dogs with nKCS, in addition to reduced tear production?

    <p>Secondary corneal ulcerations</p> Signup and view all the answers

    What is the suspected cause of nKCS in dogs that develop the condition within 1 day of applying otitis externa medications?

    <p>Terbinafine and florfenicol</p> Signup and view all the answers

    What is the site of synapse of preganglionic fibers that innervate the lacrimal gland in dogs?

    <p>Pterygopalatine ganglion</p> Signup and view all the answers

    What is the nasolacrimal duct anatomy relevant to nKCS in dogs?

    <p>Innervation of the nasal glands and lacrimal gland by postganglionic fibers running with the trigeminal nerve</p> Signup and view all the answers

    What is the documented median time from application of ear medication to documented return of clinically normal tear production in dogs with nKCS?

    <p>86 days</p> Signup and view all the answers

    What is the percentage of dogs in the study that developed a corneal ulcer as a complication of nKCS?

    <p>68%</p> Signup and view all the answers

    What is the potential underlying cause of keratoconjunctivitis sicca in horses with hypothyroidism?

    <p>Parasympathetic facial nerve dysfunction</p> Signup and view all the answers

    What is the potential consequence of otic medication use in dogs?

    <p>Neurogenic keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the role of metalloproteinases in ocular diseases?

    <p>They contribute to the development of ocular diseases</p> Signup and view all the answers

    What is the significance of the nasolacrimal duct in ocular health?

    <p>It plays a crucial role in tear drainage and ocular surface health</p> Signup and view all the answers

    What is the potential association between otitis externa and neurogenic keratoconjunctivitis sicca in dogs?

    <p>Otitis externa may be a predisposing factor for neurogenic keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the significance of parasympathetic denervation in the lacrimal gland?

    <p>It can lead to dry eye and keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the potential consequence of hypothyroidism on ocular health in horses?

    <p>Keratoconjunctivitis sicca</p> Signup and view all the answers

    What is the role of the facial nerve in lacrimal gland innervation?

    <p>It provides parasympathetic innervation to the lacrimal gland</p> Signup and view all the answers

    What is the result of pathology at any point along the efferent lacrimal gland innervation pathway?

    <p>nKCS</p> Signup and view all the answers

    What is the role of matrix metalloproteases in KCS?

    <p>They play a pathological role.</p> Signup and view all the answers

    What is the effect of denervation of postganglionic fibers in mice on basal tear secretion?

    <p>Decreased</p> Signup and view all the answers

    What is the consequence of loss of globulins and the flushing action of tears in KCS dogs?

    <p>Corneal ulcers</p> Signup and view all the answers

    What is the timeframe for return of normal tear production in nonreferral dogs?

    <p>Less than referral dogs</p> Signup and view all the answers

    What is the neural structure that was transected in rabbits to result in loss of tear production and decreased lacrimal gland size?

    <p>Superficial petrosal nerve</p> Signup and view all the answers

    What is the presumed cause of corneal ulcers in dogs with nKCS?

    <p>Secondary to nKCS</p> Signup and view all the answers

    What is the tendency of primary care veterinarians compared to ophthalmologists in rechecking dogs with nKCS?

    <p>Primary care veterinarians rechecked in shorter time frames</p> Signup and view all the answers

    Study Notes

    Neurogenic Keratoconjunctivitis Sicca (nKCS) in Dogs

    • nKCS is a suspected novel cause of neurogenic keratoconjunctivitis sicca (nKCS) secondary to florfenicol, terbinafine hydrochloride, mometasone furoate (Claro and Neptra) or florfenicol, terbinafine, betamethasone acetate (Osurnia)

    Clinical Course and Long-term Prognosis

    • 29 client-owned dogs were identified with clinical signs of nKCS after application of otitis externa medication containing terbinafine and florfenicol
    • Onset of clinical signs of nKCS within 1 day after application of otitis externa medications
    • Low Schirmer tear test value (< 15 mm/min) of affected eyes

    Research Methodology

    • Online survey and word-of-mouth recruitment were conducted to identify dogs that developed clinical signs of nKCS
    • Retrospective analysis of medical records of dogs meeting inclusion criteria

    Otitis Externa Medications

    • Terbinafine and florfenicol are suspected to cause nKCS in dogs
    • Claro and Neptra, and Osurnia are otitis externa medications containing terbinafine and florfenicol
    • Neurological manifestations of ear disease in dogs and cats (Garosi et al., 2012)
    • Occult otitis media in dogs with chronic otitis externa (Lorek et al., 2020)
    • Ototoxic effect of topical oxiconazole and terbinafine in rats (Aydın et al., 2012)
    • Canine neurogenic keratoconjunctivitis sicca (Matheis et al., 2012)
    • Evaluation of novel dry eye model (Toshida et al., 2007)

    Neurogenic Keratoconjunctivitis Sicca (nKCS)

    • nKCS is a rare and uniquely presenting form of dry eye caused by the loss of efferent innervation to the lacrimal gland.
    • It can lead to acute, complete loss of the aqueous portion of the tear film.
    • Dogs typically present with unilateral, severe ocular discomfort and a Schirmer tear test (STT) value of close to zero.
    • Concurrent ipsilateral xeromycteria and secondary corneal ulcerations are common.

    Causes of nKCS

    • Preganglionic lesions: otitis media or interna, petrositis.
    • Postganglionic lesions: total ear canal ablation, bulla osteotomy, orbital trauma.

    Efferent Lacrimal Gland Innervation Pathway

    • The pathway is complex, and pathology at any point along this pathway can result in nKCS.
    • The transection of the superficial petrosal nerve in rabbits led to loss of tear production and a decrease in lacrimal gland size.

    Clinical Relevance

    • Dogs that developed nKCS within 1 day after application of otitis externa medications containing terbinafine and florfenicol had a good prognosis for return of normal tear production within 1 year.
    • The median time from application of ear medication to documented return of clinically normal tear production was 86 days (range, 19 to 482 days).
    • Being referred to an ophthalmologist and having a deep ulcer were associated with a longer time to documentation of Schirmer tear test ≥ 15 mm/min.

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    Related Documents

    Long-lasting Otic Medications & Neurogenic Keratoconjunctivitis Sicca in Dogs PDF

    Description

    This quiz is based on a study on the signs of nKCS in dogs after medication application. It explores the causal relationship between the medication and the signs of nKCS.

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