New Diagnostic Techniques of Canine Glaucoma: The Use of Slit-Lamp Biomicroscopy, Electronic Applanation Tonometry, and Gonioscopy in Glaucoma-Affected Dogs

犬青光眼之新診斷技術：利用眼科裂隙燈臨床顯微鏡、電子數位觸碰式眼壓計及眼前房隅角檢查鏡診斷犬青光眼病例

林中天(Chung-Tien Lin) ； 王詩梅(Shi-Mei Wang)

《中華民國獸醫學會雜誌》 27卷4期 (2001/12) Pp. 239-244

https://doi.org/10.7009/JTCSVS.200112.0239

摘要

青光眼為犬隻常見之造成失明的眼睛疾病，也是常被誤診之眼科疾病。本篇介紹我們使用之犬青光眼的新診斷技術，包括利用眼科裂隙燈臨床顯微鏡、新發展之電子數位觸碰式眼壓計及隱形眼鏡式眼前房隅角檢查鏡，來診斷35隻犬青光眼病例之眼部病變。我們統計並分析35隻至國立台灣大學附設動物醫院眼科門診就診的青光眼病犬之病患資料及診斷結果如下述：這些青光眼病例雄性與雌性的比率為3:4，平均年齡約為6.9歲。最常見的病患犬種為混種犬，約佔了全部病例的34%。單側性及雙側性青光眼的發生率約為1:1；有高比率的犬隻曾患有或正患有眼前房葡萄膜炎或是水晶體異位等其他眼部疾病。這些病患之常見症狀為眼瞼痙攣、眼球變大、或失明等。我們利用幾種眼科專科檢查技術診斷青光眼及其他眼部病變，以眼科裂隙燈臨床顯微鏡、直接及間接檢眼鏡仔細檢查眼睛各部位，發現眼內虹膜括約肌麻痺及散瞳、角膜水腫、鞏膜鬱血、水晶體異位、虹膜充血及眼前房出血等為這些病例之常見眼部症狀及病變。除了臨床症狀及眼部病變檢查外，我們使用新發展之電子數位觸碰式眼壓計測量眼內壓，以確診青光眼。就診的35隻犬中，共有51個眼睛診斷為青光眼；其中有7個眼睛(14%)有青光眼的典型症狀（例如眼球腫大），但眼內壓低於30 mmHg; 26個(51%)眼內壓為30-50 mmHg，另外還有18個(35%)眼內壓高於50 mmHg。我們再利用一種新式隱形眼鏡式眼前房隅角檢查鏡Lovac Barkan goniolens，以檢查出虹膜及角膜間的眼前房隅角是否正常，我們發現部分病例的眼前房隅角較正常狹窄或是完全阻塞且伴隨有其他眼科疾病，表示這些病例為其它眼科疾病所引起的嚴重後期之二次性青光眼。根據我們利用這些眼科專科診斷技術的診斷結果及病史分析，顯示青光眼為許多其他眼科疾病最主要及共同的併發症之一。我們發現這些眼科專科診斷技術為確診犬青光眼很有用及可靠之工具，建議用於任何懷疑患有青光眼或紅眼症之病畜，以早期確診此病，早期治療，減少因眼內壓上升所造成視網膜及視神經之傷害及其他眼內病變。

關鍵字

青光眼 ； 裂隙燈 ； 眼內壓測量 ； 眼前房隅角檢查鏡 ； 虹膜角膜隅角 ； 犬

並列摘要

Glaucoma is a common and vision-threatening ophthalmic disorder in the dog. Thirty- five dogs suffering from glaucoma were presented at the National Taiwan University Veterinary Hospital (NTUVH) for ophthalmic examination. We have used ophthalmic specialist diagnostic techniques for determination of the severity and types of the 35 canine glaucoma cases by performing slit-lamp biomicroscopy, electronic applanation tonometry and contact-lens type of gonioscopy. Among the 35 canine glaucoma cases (51 offected eyes) examined, the sex ratio of the patients between males and females was 3:4. The mean age of affected dogs was 6.9 years old. The predominant affected dog breeds was crossbred/mongrel (34%). The ratio of bilateral to unilateral glaucoma was approximately 1:1. There were high proportion of the dogs with previous history or concurrent ocular disorders of anterior uveitis or lens luxation. The leading presenting signs of the glaucoma-affected dogs were blepharospasm, buphthalmos (enlarged globe), and blindness at their first admission. A variety of ophthalmic and glaucoma diagnostic techniques have been used to diagnose glaucoma and accompanying ocular les ions. Ophthalmic examination using slit-lamp biomicroscope and indirect/direct ophthalomoscopes revealed that mydriasis, corneal edema, episcleral congestion, lens luxation, uveitis, and hypema were common ocular findings in these affected dogs. The diagnosis of glaucoma was confirmed by the measurement of intraocular pressure (IOP) using an electronic Tonopen applanation tonometer. Among 51 glaucomatous eyes of the 35 dogs, 7 eyes (14%) showed IOP reading less than 30 mmHg but with glaucoma signs, 26 eyes (51%) with IOP between 30-50 mmHg, and 18 eyes (35%) with IOP more than 50 mmHg. Gonioscopic examination was performed using a Lovac Barkan goniolens for determination of the opening of the iridocorneal aqueous humor filtering angle. Based on the results of thorough ophthalmic examination, most of the glaucoma cases were at an advanced stage of glaucoma with narrow (to close) angles or obstructed iridocorneal filtering angles. Most of the were secondary glaucoma and occurred following other ocular diseases. These clinical findings based on the techniques suggest that glaucoma is a major and common complication of various other primary ocular diseases. We find that these ophthalmic specialist diagnostic techniques are powerful and reliable for diagnosis of the glaucoma cases and they should be used for any glaucoma-suspected cases or red eye cases on a routine basis.

並列關鍵字

Glaucoma ； Slit-lamp ； Tonometry ； Goniolens ； Gonioscopy ； Iridocorneal angle ； Dog