Peer-reviewed veterinary case report
Dogs with nodular granulomatous episcleritis causing eye cornea lumps
By Hamzianpour, Negar et al.·Published in Veterinary ophthalmology·2019·Eye Veterinary Clinic Ltd, United Kingdom·View original on PubMed →
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Original publication title: Clinical and pathological findings in three dogs with a corneocentric presentation of nodular granulomatous episcleritis.
- Species:
- dog
Plain-English summary
Three dogs were brought in for a non-painful, unusual growth on the surface of one eye. Initial treatments didn’t help, so vets performed biopsies and, in two cases, removed the eye to prevent potential cancer. The tests showed that the growth was due to a specific type of inflammation called nodular granulomatous episcleritis, which was surprisingly only affecting the cornea. After the surgeries, the dogs recovered well, and the one dog that didn’t have surgery is being managed with medication to control the inflammation.
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Abstract
PURPOSE: To describe the clinical signs, management, histopathologic findings, and outcome of three dogs with a corneocentric presentation of nodular granulomatous episcleritis (NGE). METHODS: Three dogs of varying breeds were presented for a unilateral, nonpainful, and infiltrative corneal lesion in the dorsal aspect of the eye. Clinical response to symptomatic topical treatment directed at a presumed inflammatory or immune-mediated cause was poor. Due to this, and concerns of neoplasia, ultrasonography (n = 1), incisional biopsy (n = 2), and/or enucleation (n = 2) were performed. RESULTS: The inflammatory infiltrate observed on histopathology was identical to that seen in nodular granulomatous episcleritis in all three cases. However, atypically the inflammation was confined to the cornea and limbus, without episcleral or conjunctival involvement. Inflammation of the cornea was full thickness to Descemet's membrane. Following enucleation (n = 2), there were no postoperative complications, and no reported ophthalmic disease in the remaining eye. Currently, the single non-enucleated case remains controlled with systemic and topical immunosuppression. CONCLUSION: To the best of the authors' knowledge, this is the first report of an NGE condition purely affecting the full thickness of the cornea, without episcleral or conjunctival involvement. The authors propose this to represent an atypical corneocentric variant of NGE. This clinical presentation can resemble neoplasia; incisional biopsy is recommended for a definitive diagnosis. Further research into the optimal treatment strategies for this variant of NGE is required.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30724453/