Canine endotheliitis: Clinical characteristics, advanced imaging features, and treatment

• Published in: Veterinary ophthalmology Vol. 25; no. S1; pp. 185 - 192
• Main Authors: Mayes, Melaney A., Casanova, Maria Isabel, Park, Sangwan, Steele, Kirsten, Linton, Lana, Kim, Soohyun, Good, Kathryn L., Moore, Bret A., Newbold, Georgina M., Leonard, Brian C., Li, Jennifer Y., Thomasy, Sara M.
• Format: Journal Article
• Language: English
• Published: England 01.05.2022
• Subjects: Animals; Cornea; Corneal Diseases - veterinary; corneal edema; Corneal Edema - diagnostic imaging; Corneal Edema - drug therapy; Corneal Edema - veterinary; Corneal Pachymetry; Dog Diseases - diagnostic imaging; Dog Diseases - drug therapy; Dogs; Endothelial Cells; endotheliitis; Endothelium, Corneal; in vivo confocal microscopy; Microscopy, Confocal - veterinary; optical coherence tomography; ROCK inhibitor; in vivo confocal microscopy; ROCK inhibitor; endotheliitis; optical coherence tomography; corneal edema
• ISSN: 1463-5216; 1463-5224
• DOI: 10.1111/vop.12967

Objective To describe the clinical findings, multimodal corneal imaging features and treatment in canine patients diagnosed with endotheliitis. Animals studied Four canine patients met inclusion criteria for bilateral corneal disease with endothelial inflammation and secondary corneal edema that responded to topical anti‐inflammatory treatment. Methods The patients selected underwent a complete ophthalmic examination with emphasis on the cornea including ultrasound pachymetry (USP), Fourier‐domain optical coherence tomography (FD‐OCT), in vivo confocal microscopy (IVCM), and digital slit lamp photography. Results All patients in this study demonstrated thickened corneas due to edema with USP and FD‐OCT. With IVCM, mild to severe polymegathism and pleomorphism of corneal endothelial cells, reduced endothelial cell density, hyperreflective keratic precipitates (KPs), and extracellular debris as well as hyporeflective pseudoguttata were observed. With FD‐OCT, hyperreflective KPs were commonly observed on the inferior cornea. Clinical examination and advanced imaging results were consistent with a diagnosis of endotheliitis. All patients initially responded to topical anti‐inflammatory treatment and required continued therapy; two patients also received topical netarsudil, a rho‐associated coiled‐coil kinase inhibitor. Conclusion Endotheliitis should be considered for canine patients with bilateral edema that is most severe in the inferior cornea. Careful inspection of Descemet's membrane–endothelial complex should be performed for KPs or inflammatory debris. Chronic administration of topical anti‐inflammatories may be necessary to prevent flare‐ups of endotheliitis.