A retrospective analysis of lipid‐laden aqueous humor in dogs: Thirty cases

Abstract

Objective To describe the clinical presentation and outcome of canine patients that present with lipid‐laden aqueous humor (LLA) and to evaluate its association with other ocular and systemic disorders. Methods Medical records were identified and reviewed of 30 dogs presenting with clinical signs of LLA between 2013 and 2017 and compared to the canine referral population during the same time period. The percentage of dogs affected by LLA and potential risk factors were compared between groups. Results There were 40 eyes in 30 dogs with LLA out of 8011 (0.4%) referrals. The mean age of dogs with LLA was significantly younger than dogs without LLA (P = .0334). Sex was not associated with LLA. Miniature Schnauzers were more likely to have LLA than mixed breeds (P < .0001). Incidence of LLA was significantly higher in eyes also affected by corneal ulceration (P = .0018) or phacoemulsification (P = .0001). Sixty‐two percent and 51% of dogs with LLA had concurrent diabetes mellitus and hypertriglyceridemia, respectively. Average triglyceride level of dogs with LLA was 1087 mg/dL (±544) (reference 50‐150 mg/dL) and average cholesterol level was 575 mg/dL (±232) (reference 125‐300 mg/dL). Complete resolution of LLA was achieved in all dogs re‐examined with an average of 20.2 days (range 4‐175 days) after diagnosis. There were 6/30 dogs lost to follow‐up. Recurrence of LLA occurred at least once in 4/24 dogs (16.7%) after resolution. Conclusions Lipid‐laden aqueous humor occurs more frequently in Miniature Schnauzers. Corneal ulceration and phacoemulsification are risk factors. Complete resolution was seen in all cases with a low incidence of recurrence.

Lipemic aqueous humor and suspected xanthomas associated with primary hypertriglyceridemia in a cat

“…The clinical signs usually occur after 6–9 months and include cutaneous xanthomas, lipid granulomas in abdominal organs and peripheral neuropathies 10–14 . Ophthalmic presentations described to date include lipemic aqueous humour, lipemia retinalis, lipid keratopathy, arcus lipoids corneae and corneal stromal dystrophy 4–7,15–18 . Xanthomas of the eyelid or third eyelid are reported in other species such as dogs, rabbits and birds 11,13,19 .…”

“…[10][11][12][13][14] Ophthalmic presentations described to date include lipemic aqueous humour, lipemia retinalis, lipid keratopathy, arcus lipoids corneae and corneal stromal dystrophy. [4][5][6][7][15][16][17][18] Xanthomas of the eyelid or third eyelid are reported in other species such as dogs, rabbits and birds. 11,13,19 The main approach to confirm the diagnosis is to exclude other disease that cause elevation of the blood lipoproteins (such as diabetes mellitus, pancreatitis, hypothyroidism, etc.…”

Prevalence of ocular findings and their association with glycemia in dogs with diabetes mellitus: A 10-year clinical study (2009-2019)

“…Ocular findings being historically associated with DM in dogs are as follows: keratoconjunctivitis sicca ( Cullen et al , 2005 ; Williams et al , 2007 ; Gemensky-Metzler et al , 2015 ), polymegathism and pleomorphism in corneal endothelial cells ( Yee et al , 1985 ), corneal hypoesthesia ( MacRae et al , 1982 ), non-healing corneal ulcers ( Good et al , 2003 ), lipid keratopathy ( Crispin, 2002 ), corneal xanthogranulomas ( Harvey et al , 2020 ), corneal abscesses ( Michau, 2020 ), intracorneal stromal hemorrhages ( Matas et al , 2012 ; Violette and Ledbetter, 2017 ), lipid-laden aqueous humor ( Violette and Ledbetter, 2019 ; Schechtmann et al , 2020 ), cataracts ( Miller and Brines, 2018 ), lens-induced uveitis ( Paulsen et al , 1985 ), phacomorphic glaucoma ( Williams, 2004 ), vitreous degeneration ( West et al , 2020 ), non-proliferative retinopathy ( Landry et al , 2004 ), and peripheral neuropathies ( Katherman and Braund, 1983 ). Unfortunately, until now, there are no studies reporting the prevalence of ocular findings in diabetic canine patients nor the association between those and glucose blood levels.…”