Az eosinophil granulocytás (proliferatív) keratitis macskákban
Abstract
Summary
Feline eosinophilic keratitis is a chronic, proliferative inflammation of the cornea.
Pathogenesis: The exact pathogenesis is still unknown, it may involve infection
with FHV-1 (Feline herpesvirus-1).
Clinical presentation: The disease is usually unilateral and appears more often
in young and middle-aged castrated males. First symptom is perilimbal corneal
vascularisation. As the disease progresses irregular, white-pink plaques appear on
the dorsotemporal or ventronasal quadrant of the cornea. The lesions are usually
covered with corneal epithelium, ulceration is seen only 25% of the cases.
Diagnosis: Clinical presentation is typical for the disease. Corneal scraping can verify the diagnosis. Detection of one eosinophil or mast cell in cytology is diagnostic.
Treatment: Treatment usually consists of topical corticosteroids (0.1% dexamethason- or prednisolon-acetate) and cyclosporine. Some cats develop adverse reaction to topical treatment. In these cases, systemic medication is necessary. Oral
megestrol acetate is an effective treatment for eosinophilic keratitis but there are
potential side effects, such as diabetes mellitus, pyometra and mammary gland
tumour. Therefore, megestrol acetate is only used if topical treatment cannot be
maintained. As the role of herpesvirus in the disease is still unclear, additional treatment with famciclovir is recommended. Initial response to the therapy usually good
but over time recurrence rate is more than 50%.