In fact, the most a large number of We receive information through our eyes. It is the ability to see and analyze the picture we see that allows us to adequately interact with each other, learn and perform other vital actions. That is why it is extremely important to take care of eye health and promptly identify various pathologies and other operational disruptions visual apparatus. That is why we recently looked at visual impairment in children and how visual impairment can be prevented. After all, some diseases can cause irreversible damage, cause damage to the cornea of the eye, against which a complication such as pannus can develop, the treatment of which we will consider on this page www..
Pannus is a rather rare pathological condition: superficial diffuse inflammatory lesion of the cornea. This disease most often diagnosed with trachoma, which in turn is an infectious disease of the conjunctiva of the eyes and is accompanied by damage to the cornea.
Pannus of the eye can also sometimes occur with the phlyctenular form of keratoconjunctivitis, as well as with corneal degeneration.
Pannus translated from Latin means “piece of fabric” or “flap”. In ophthalmology, this term is used to refer to a lesion of the limbus, as well as the cornea, which looks like a flap descending from top to bottom. Corneal pannus develops due to local chronic inflammatory lesion. As a result of pathological processes, a highly vascularized tissue appears under the epithelium of the cornea. lymphoid infiltration, which gradually moves towards the limbus towards the center of the cornea.
With trachoma, the vascularized infiltrate is replaced by scar tissue, as a result of which the patient's visual acuity decreases by an order of magnitude. Depending on the degree of clouding of the cornea, as well as the number of vessels in it, doctors distinguish several types of pannus, namely thin, vascular, as well as thick and fleshy. With trachoma, this disorder is most often characterized by massiveness and fleshiness. However, in other cases, the pannus may not be so pronounced, so the transparency of the cornea is not greatly impaired. Strong - not strong, but you can’t leave it as it is. Therefore, we need to talk about how damage to the cornea of the eye is corrected, what treatment helps.
Treatment of corneal lesions
Treatment for pannus depends directly on the cause of its appearance. Treatment should be vigorous; it involves correction of the underlying disease. In order to eliminate pathological vascularization, doctors resort to laser therapy. Proteolytic enzymes can also be used. In some cases, successful recovery is only possible with keratoplasty.
Laser treatment
To eliminate pannus, phototherapeutic keratectomy is often used. To carry out this procedure, the patient is given local anesthesia, and then a small amount of the cornea is removed using heat-generating laser beams. Surface grinding is also carried out.
Phototherapeutic keratectomy is performed in outpatient setting. After such an operation, the patient needs to use antibiotics for some time, eye drops or ointments. For six months, the patient must always keep tear fluid substitutes with him.
Other laser treatment techniques may also be used.
It is worth considering that laser treatment It is strictly contraindicated for patients whose age has not exceeded eighteen years. Also, such therapy is impossible if the refractive power of the eye changes during the last two years, during pregnancy and breastfeeding. Among other things, the use of a laser is impossible for some eye diseases, including cataracts and glaucoma, chronic diseases of the cornea. Contraindications for such treatment also include immune diseases And diabetes.
Keratoplasty
This surgical intervention helps to cope with pannus, which can no longer be treated with more conservative and less traumatic methods. Keratoplasty is a microsurgical surgical intervention that involves transplanting the cornea. The affected area of the cornea is replaced with a donor graft.
Since such fabric practically does not contain blood vessels, the donor site in most cases takes root easily. Surgery carried out under local anesthesia. In this case, the patient must first undergo antimicrobial therapy, he is also instilled with glucocorticosteroids, which can prevent possible reactions rejection. Sutures from the eye are removed only two months after the operation, and within a couple of years the patient must refuse heavy loads.
Conservative treatment
IN mild form pannus may give in conservative treatment. In this case, the patient is prescribed eye ointments or antibiotic drops. Therapy is often carried out in an inpatient department. If such treatment is not effective enough, antibiotics are also prescribed oral form or by injection. In addition, a patient with such a disorder is advised to take vitamin preparations, sometimes used antihistamines and various immunomodulators.
All eye diseases should be treated exclusively under the supervision of a qualified ophthalmologist. Self-medication can cause many complications and disorders. If detected early, corneal lesions such as pannus can be successfully treated.
Pannus - the disease is mainly registered in German Shepherds, but also occurs in other dog breeds. It is manifested by changes in the cornea: the proliferation of blood vessels and scar tissue. This process, as a rule, begins in the lateral or ventral quadrant of the cornea and subsequently spreads to the entire surface of the cornea, which can lead to blindness. The cornea becomes black due to the accumulation of pigment.
The main view is that pannus is an immune-related disease. Such cellular changes in the cornea begin when the cornea is recognized (perceived) by the body and immune system as foreign tissue or a graft. It is assumed that German Shepherds are predisposed to this disease, but an important factor influencing the development of the disease is ultraviolet irradiation. Pannus was first discovered in Austria and the USA, Colorado, both areas are highly elevated. Today, pannus is reported throughout the world, however, the causes have not yet been fully identified, and it is very difficult to treat, especially in high mountain areas, which confirms the UV theory.
Treatment is aimed at reducing the immune response locally. Steroids are used (dexamethasone and prednisolone), which have anti-inflammatory and immunosuppressive effects, and cyclosporine is a drug with an immunosuppressive effect. Cyclosporine is used topically as monotherapy or in combination with steroids, which improves treatment outcome compared with the use of steroids alone.
Cyclosporine has been used to treat pannus by veterinarians for about 12 years. A 1% or 2% solution is used, based on olive, corn or vegetable oil. About 5 years ago they started using 0.2% cyclosporine in the form of an eye ointment called Optimmune. It is now successfully used to treat other eye diseases, such as: “dry eye syndrome”. In the case of pannus, they concluded that a 0.2% solution is less effective than 1%. After treatment, active vascularization and granulation may disappear, but scar tissue and pigment resolve extremely slowly or do not change at all.
Recently, the drug cyclosporine Neoral was released in the form of a microemulsion. The microemulsion can be dissolved in solutions other than oil. This is an advantage over oil solutions, since oil can irritate the skin around the eyes, and can also stain furniture (when an animal rubs its muzzle, for example, on a sofa). Cyclosporine can be mixed with aqueous solutions dexamethasone or prednisolone, thereby increasing the effect of treatment. At first in some dogs new solution caused irritation, but after a few weeks of use it disappeared.
As usual, pannus accompanies a disease such as plasmoma - this is an increased immune reaction at the border of the third eyelid and the conjunctiva and is manifested by plasmatic lymphoid conjunctivitis. This condition is also more common in German Shepherds. Compared to pannus, plasmoma has less impact on vision, can cause discomfort, and is less treatable.
Reducing exposure to UV radiation also helps reduce the rate of pannus development. Keeping dogs indoors sunny days or use special sunglasses for dogs reduces the likelihood of the occurrence and development of pannus.
Eyes - they are both “soul mirrors” and reflections general health the body too. When a dog's eyes are clean, clear and bright, then your pet is most likely completely healthy. But if it’s the other way around... Pannus in dogs will not be noticed unless the animal’s owner is blind, since this disease manifests itself very “visually” in every sense of the word.
In normal terms, this is what is called ulcerative keratitis in German Shepherds. It is they who are predisposed to Germans of both varieties, as well as their crosses. Other dog breeds do have the disease, but in extremely rare cases. The disease can be detected in a shepherd dog at any age, but more often it occurs around the age of four. The older the dog, the higher the likelihood of developing pannus.
In what cases should you sound the alarm and urgently take your pet to the veterinarian? It’s simple: this needs to be done if the dog’s cornea has suddenly acquired a noticeably brownish tint, sprouted blood vessels are clearly visible on its surface, or the cornea has become very dark and cloudy. The pathological process, if it has already “started”, will quickly gain momentum over time.
As a rule, it ultimately ends in the formation of deep ulcers on the surface of the cornea and its subsequent scarring. As a result, the dog completely loses his vision. Even if the process in advanced cases can be stopped, the animal becomes disabled, its visual acuity is greatly deteriorated.
But for last years Veterinarians have been able to identify many predisposing factors that significantly increase the likelihood of developing pathology:
- Excessive ultraviolet radiation has been shown to dramatically increase the incidence of pannus. Therefore, German shepherds living close to the Arctic Circle or in mountainous areas get sick much more often. If you live in these areas, you should limit the time your sick pet spends outside.
- It is assumed that disturbances in the functioning of the immune system play a significant role in the emergence of this pathology. Many veterinarians consider pannus to be a form autoimmune disease, in which the body itself begins to attack the corneal tissue.
- Presumably it can be considered that this specific form keratitis can be “stimulated” by certain pathogens infectious diseases. But on this moment There is no reliable evidence for this theory.
How is this disease diagnosed? Everything is simple here: in total clinical signs and the breed of the animal. Now let’s talk about what treatment regimen can be used for this disease.
Therapeutic techniques
Let us immediately warn you that to date there is not a single therapeutic method that could guarantee long-term remission of the disease. But this is not a reason to give up: if you start supporting and symptomatic treatment on early stages, there is every chance to slow down the pathological process so that the quality of life of your pet remains at the same level. It is important to understand that ulceration and inflammatory processes even in this case, they are completely reversible, but scars, if they have already formed on the surface of the cornea, cannot be removed. The goals of therapy are to completely eliminate active vascularization (sprouting of blood vessels) and prevent further progression of scarring and pigment deposition in the cornea. Today there are three approaches to the treatment of pannus.
Chronic keratoconjunctivitis that develops due to autoimmune disorders in dogs is called pannus. The disease affects the limbus and cornea. The infiltrate that forms over time under the cornea is replaced by scar tissue, which leads to vision deterioration and even loss.
Causes of pannus in dogs
The exact etiology is unknown. Presumably the influence of hereditary factors, since the disease is characteristic of certain breeds, which include:
- German and East European Shepherds (also their crossbreeds).
- Husky.
- Dachshunds.
It occurs much less frequently in representatives of other breeds.
It has been proven that pannus in dogs develops under the influence of ultraviolet radiation, since the disease is most often diagnosed in areas with increased activity ultraviolet.
Pannus eye development mechanism
The autoimmune nature of the pathology is beyond doubt. Main role plays in the emergence and development the immune system, recognizing subcellular changes in the cornea as foreign. Further defense mechanisms trying to neutralize pathological processes, leading to rejection of the outer membrane of the eye.
The influence of ultraviolet radiation leads to an acceleration of metabolic processes in the cornea, which forces the immune system to react more actively to “foreign” tissues. Therefore, pannus of the eye has become so widespread in regions with increased exposure to ultraviolet radiation.
Corneal pannus symptoms
At the onset of the disease, due to the proliferation of epithelial cells, infiltrates of plasma cells and lymphocytes are formed in the stroma. As it progresses, the cornea becomes neovascularized and becomes cloudy. No treatment immune cells, entering the cornea from the formed vessels, cause its rejection.
The most common symptoms of corneal pannus are::
- Dry eye syndrome.
- Redness.
- Swelling caused by the process of neovascularization.
- Cloudiness of the eye.
- Corneal syndrome (blepharospasm, lacrimation, photophobia).
- Externally visible are lumpy pink-red growths interspersed with brown pigmentation.
The disease affects both eyes, but the rate of development may differ in each eye. Typically, the initial manifestations are visible in the temporal quadrant, eventually moving to the entire cornea.
Diagnosis of pannus
Making a diagnosis in most cases is not difficult. In addition to detecting characteristic clinical picture, finding out the region of residence of the animal and its breed requires a series of diagnostic procedures which include:
- Inspection using focal illumination.
- Biomicroscopy. It is carried out to more accurately characterize the changes occurring.
- Cytological examination of scrapings from the cornea and conjunctiva. Only this method allows you to confirm the diagnosis of pannus. In most cases, scrapings reveal lymphocytes and plasma cells that have completely replaced normal cells.
- For differential diagnosis sometimes stained with fluorescein. It should be understood that this method can confuse the veterinarian, since in some cases a color characteristic of a corneal ulcer is revealed. This leads to the beginning improper treatment, which has no effect.
Only A complex approach allows you to confirm the presence of an autoimmune process of the cornea and prescribe the correct treatment.
Pannus in dogs treatment
Autoimmune diseases cannot be completely cured. The main method of treatment is symptomatic. If pannus is diagnosed in dogs, treatment must be carried out in a course for life. The veterinarian develops a regimen according to which medications are taken during periods of exacerbation, and preventive measures during remission.
The goal of treatment is:
- Reduction of the affected area.
- Preventing the spread of the disease to neighboring areas, preventing blindness.
- Reducing the aggressiveness of the immune system.
At the initial stages, it is possible to prescribe glucocorticosteroids, but long-term use of drugs in this group often causes an increase in intraocular pressure. Basic medicines– immunosuppressants, among which the most common is Cyclosporin A. It comes in the form eye drops, ointment and solution for oral use. The last option is the least preferable due to possible complications from the liver and kidneys. Usage local forms Cyclosporine prevents side effects, maintaining local impact.
Therapy begins with aggressive doses that are reduced as symptoms resolve. Next, maintenance doses are prescribed.
Exists surgical method correction - superficial keratectomy, but it is rarely used due to frequent postoperative complications.
To reduce the effect of ultraviolet radiation on the cornea, veterinarian may recommend wearing special sunglasses for animals.
With this they read:
Ophthalmology for animals
Anatomy, hygiene, and other related factors often contribute to the development of eye problems throughout your pet's life. Diseases such as conjunctivitis can be treated quite quickly, but in some cases only a qualified veterinary ophthalmologist can help the animal
Keratitis in dogs: symptoms and treatment
Keratitis in dogs is a disease that is characterized by inflammation of the cornea of the eye, usually has a pronounced symptomatic picture and must be diagnosed in order to prescribe the correct treatment.
Cataracts in dogs: symptoms and treatment
Cataracts in dogs are a common ophthalmological disease that worsens a dog’s vision and can also cause complete blindness. Cataracts in dogs are clouding of the lens, which prevents the passage of light into the eye.
Pannus This is a progressive autoimmune inflammation of the cornea in dogs. It is also called chronic diffuse superficial keratoconjunctivitis (shepherd keratitis).
Animals of all ages are susceptible to this disease. There is a certain predisposition to it in such dog breeds as: German Shepherd, miniature pinscher, Greyhound, Siberian Husky, Dalmatian, etc.
Causes
Pannus occurs in dogs as a result of the body's autoimmune reaction to corneal cells. Speaking in simple words, the body considers its own cells to be foreign, so it begins to actively “attack” them, which contributes to the transition of the disease to a chronic progressive course.
Symptoms
As a rule, the symptoms of pannus are quite characteristic and are accompanied by: clouding of the cornea (starts near the limbus), germination of blood vessels (vascularization), formation of granulation tissue, and often deposition of dark pigment. Similar problems can affect the animal's conjunctiva and third eyelid. With absence timely treatment by an ophthalmologist, the dog appears Feel foreign body in the eye, lacrimation, blinking becomes more frequent. The quality of the animal’s vision deteriorates, and in severely advanced cases there is a complete loss of visual function.
Diagnostics
The diagnosis is made based on comprehensive examination dog veterinarian ophthalmologists performing tests and biomicroscopy of the cornea. Pannus is a chronic progressive disease, as a result of which It is extremely important to diagnose it at the initial stage.
Treatment
Treatment is carried out by applying medicines for the eyes for a long time ( sometimes for life!) and periodic monitoring of pathology by a veterinary ophthalmologist.
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