p.10
Histopathology of Scleritis
What is the typical histological characteristic of episcleritis?
Usually nonulcerated and relatively free of inflammatory cells.
p.6
Surgically Induced Scleritis
What is the most common surgery associated with SINS?
Cataractous lens extraction.
p.3
Classification of Episcleritis and Scleritis
How is episcleritis in dogs categorized?
As primary (idiopathic) immune-mediated unilateral or bilateral focal or diffuse episcleritis, bilateral nodular episclerokeratitis of collie-type dogs, and secondary episcleritis with discernible etiology.
p.18
Immune-Mediated Inflammatory Conditions
What condition is discussed in the study by Gwin et al. (1977)?
Ophthalmic nodular fasciitis in dogs.
p.14
Histopathology of Scleritis
What histological finding was noted in the dog with necrotic scleritis?
Multiple areas of collagen necrosis.
p.3
Clinical Manifestations and Diagnosis
What is the difference between episcleritis and scleritis in terms of severity?
Episcleritis tends to be benign and self-limiting, while scleritis is painful and more vision-threatening.
p.3
Clinical Manifestations and Diagnosis
What is a common characteristic of nodular episclerokeratitis in collie-type dogs?
Inflamed masses on the eyelid margin, temporal limbus, cornea, and third eyelid, often bilateral and symmetric.
p.9
Immune-Mediated Inflammatory Conditions
What are the unique features identified in bilateral episclerokeratitis?
They often require lifelong topical or systemic immunosuppression.
p.12
Treatment Options for Episcleritis and Scleritis
What is the treatment of choice for nonnecrotizing scleritis in dogs?
Immunosuppression with oral prednisolone and azathioprine.
p.17
Immune-Mediated Inflammatory Conditions
What is the main topic of the study by Fong et al. (1991)?
Immunopathology of scleritis.
p.2
Pathogenesis and Anatomy of the Sclera
How does the sclera receive most of its nutrients?
By diffusion from the vasculature of the suprachoroid and Tenon's capsule.
p.2
Classification of Episcleritis and Scleritis
What are the classifications of scleritis according to Fischer?
Superficial, deep nonnecrotizing, and necrotizing.
p.6
Histopathology of Scleritis
How does scleritis associated with systemic autoimmune disease typically present histologically?
With zonal granulomatous scleral inflammation.
p.3
Prognosis and Complications
What is the relationship between scleritis and systemic autoimmune disease?
Scleritis is often associated with systemic autoimmune disease.
p.1
Secondary Causes of Episcleritis and Scleritis
What are some secondary causes of episcleritis and scleritis in dogs?
Infections (e.g., Ehrlichia canis), parasitic infestations (e.g., Onchocerca spp), and ocular trauma.
p.10
Secondary Causes of Episcleritis and Scleritis
What type of cellular infiltrates are associated with secondary episcleritis caused by foreign bodies?
Granulomatous infiltrates containing more macrophages, giant cells, and leucocytes.
p.17
Secondary Causes of Episcleritis and Scleritis
What systemic diseases are associated with scleritis according to Sainz de la Maza et al. (1995)?
Scleritis is associated with systemic vascular diseases.
p.11
Histopathology of Scleritis
What types of episcleritis have been categorized immunohistochemically?
Focal, diffuse, and nodular episcleritis.
p.9
Clinical Manifestations and Diagnosis
What laboratory evaluations are performed for dogs with episcleritis?
Complete blood counts, serum biochemistry profiles, and urinalyses.
p.15
Treatment Options for Episcleritis and Scleritis
What is the treatment for E. canis scleritis and episcleritis?
Doxycycline (5 mg/kg orally for a minimum of 3 weeks), topical corticosteroids, NSAIDs, and mydriatics as required.
p.7
Prognosis and Complications
What ocular complications are commonly associated with necrotizing scleritis?
Decreased vision, anterior uveitis, cataract formation, peripheral ulcerative keratitis, glaucoma, and fundus abnormalities.
p.16
Classification of Episcleritis and Scleritis
What are the two clinical and pathologic conditions of idiopathic scleritis?
Nonnecrotizing scleritis and necrotizing scleritis.
p.13
Treatment Options for Episcleritis and Scleritis
What treatment is required for managing necrotic scleritis?
Immunosuppression with oral azathioprine and steroids, requiring lifelong therapy.
p.8
Clinical Manifestations and Diagnosis
What variant forms of nodular granulomatous episclerokeratitis have been reported?
Anterior uveal granulomas and granulomatous blepharitis.
What are the common causes of infectious scleritis?
Bacterial, viral, parasitic, fungal, or amoebal organisms.
p.14
Clinical Manifestations and Diagnosis
What condition was observed in the left eye of the dog with necrotic scleritis?
Avulsion of the dorsal rectus muscle causing strabismus.
p.10
Secondary Causes of Episcleritis and Scleritis
What can special stains reveal in cases of secondary episcleritis?
The organisms or foreign bodies causing the condition.
p.6
Surgically Induced Scleritis
What is the mean time to presentation for SINS after surgery?
9 months, but some may remain latent for several years.
p.17
Histopathology of Scleritis
What does the research by Wilhelmus et al. (1981) explore?
Histopathologic and clinical associations of scleritis and glaucoma.
p.13
Clinical Manifestations and Diagnosis
How is necrotic scleritis diagnosed?
Through light microscopic examination of biopsies of affected sclera.
p.8
Classification of Episcleritis and Scleritis
Which dog breeds seem to be predisposed to unilateral focal or diffuse episcleritis?
American Cocker Spaniel and Golden Retriever.
p.15
Classification of Episcleritis and Scleritis
What is idiopathic episcleritis categorized into?
Unilateral and bilateral focal or diffuse forms, and bilateral nodular episclerokeratitis.
p.16
Prognosis and Complications
What is the prognosis for scleritis and necrotic scleritis?
The prognosis is guarded and requires long-term systemic immunosuppression.
p.10
Histopathology of Scleritis
Where is the inflammation centered in episcleritis?
On the episcleral tissues and corneal stroma.
What systemic infections can cause scleritis?
Toxoplasmosis, syphilis, tuberculosis, Lyme disease, leprosy, and toxocariasis.
p.12
Prognosis and Complications
What are the potential complications associated with extensive or chronic nonnecrotizing scleritis?
Choroiditis with focal flat serous retinal detachments and retinal degeneration.
p.2
Pathogenesis and Anatomy of the Sclera
What is the significance of Tenon's capsule in relation to the sclera?
It is a loose fibrovascular net on the outer surface that aids in nutrient diffusion.
p.1
Classification of Episcleritis and Scleritis
What breeds of dogs may inherit immune-mediated bilateral episcleritis disorders?
Collies, American cocker spaniels, and golden retrievers.
p.15
Clinical Manifestations and Diagnosis
How is the diagnosis of E. canis scleritis and episcleritis confirmed?
Through biopsy, culture, polymerase chain reaction, and immunofluorescence laboratory procedures.
p.13
Immune-Mediated Inflammatory Conditions
What is necrotic scleritis in dogs?
A rare unilateral or bilateral aggressive inflammatory condition of the sclera affecting the choroid and episclera.
p.16
Histopathology of Scleritis
What is the predominant inflammatory infiltrate observed in episcleritis?
A mixed inflammatory infiltrate with lymphocytes, plasma cells, fibroblasts, and macrophages.
p.9
Histopathology of Scleritis
What is a non-specific finding reported in nodular episclerokeratitis?
Focal vascular hyalinization.
p.13
Histopathology of Scleritis
What types of inflammatory cells are commonly found in necrotic scleritis?
Mononuclear cells, including lymphocytes and plasma cells, with occasional giant cells and epithelioid macrophages.
p.11
Histopathology of Scleritis
What histological changes are reported in biopsies of focal and diffuse episcleritis?
Increased amounts of collagen and thickened hyalinized collagen fibers.
p.4
Prognosis and Complications
What are potential ocular complications of episcleritis?
Anterior uveitis, glaucoma, and cataract formation.
p.3
Classification of Episcleritis and Scleritis
What are the categories of scleritis?
Idiopathic nonnecrotizing scleritis, necrotic scleritis, and scleritis secondary to trauma, infectious organisms, and surgery.
p.10
Histopathology of Scleritis
What are the histologic features of pannus and pigmentary keratitis?
Increased epithelial and subepithelial pigmentation and fibrovascular tissue associated with the superficial cornea.
p.6
Histopathology of Scleritis
What is the basic histopathologic lesion in scleritis?
Granulomatous inflammation surrounding necrotic scleral collagen.
p.10
Histopathology of Scleritis
What is a characteristic finding in granulomatous episcleritis?
Foamy macrophages containing acid-fast bacteria.
p.12
Clinical Manifestations and Diagnosis
How is the diagnosis of nonnecrotizing scleritis confirmed?
By a scleral biopsy and light microscopic examination revealing granulomatous or inflammatory scleritis.
p.16
Clinical Manifestations and Diagnosis
How does the neighboring cornea respond in cases of episcleritis?
It may exhibit focal edema, vascularization, and degeneration.
p.15
Prognosis and Complications
What characterizes traumatic scleritis and episcleritis?
It is usually mild and responds promptly to symptomatic anti-inflammatory therapy.
p.8
Clinical Manifestations and Diagnosis
What are the common clinical manifestations of episcleritis?
Congested vascular response near the limbus, focal or diffuse lesions, and edematous cornea.
p.15
Histopathology of Scleritis
What are the light microscopic features of necrotic scleritis?
Diffuse inflammatory cells and collagen necrosis.
p.8
Classification of Episcleritis and Scleritis
What is the significance of the term 'nodular' in relation to episcleritis?
It is not included to avoid confusion, as nodular episclerokeratitis is a developmental condition that may be inherited.
p.10
Histopathology of Scleritis
How do pannus and pigmentary keratitis differ from episcleritis?
They have less extensive cellular infiltrates and are characterized by pathognomonic clinical manifestations.
p.1
Immune-Mediated Inflammatory Conditions
What are the primary inflammatory conditions affecting the episclera and sclera in dogs?
Episcleritis and scleritis, which are assumed to be primary and immune-mediated.
p.15
Clinical Manifestations and Diagnosis
What are the common clinical signs of E. canis scleritis and episcleritis?
They are similar to idiopathic immune-mediated episcleritis and scleritis.
p.18
Immune-Mediated Inflammatory Conditions
What condition related to canine ocular health was reviewed by Zarfoss et al. (2005)?
Canine ocular onchocerciasis.
p.7
Treatment Options for Episcleritis and Scleritis
What may be required if inflammation is unresponsive to systemic corticosteroids?
Adjunctive immunosuppressive therapies.
p.4
Clinical Manifestations and Diagnosis
What characterizes nodular episcleritis?
Localized redness and edema with a 2- to 3-mm intraepiscleral nodular elevation.
p.1
Pathogenesis and Anatomy of the Sclera
What is the significance of the optic meninges in relation to the episclera?
They are fused to the episclera at the posterior pole of the globe around the optic nerve.
p.4
Episcleritis and Scleritis in Dogs
What is scleritis?
Inflammation of the sclera, typically a severe and painful condition that may involve other ocular structures.
p.16
Histopathology of Scleritis
What unique feature is observed in necrotizing scleritis?
Focal areas of collagen necrosis and collagenolysis.
p.8
Prognosis and Complications
What is the prognosis for most types of episcleritis and nodular episclerokeratitis?
They respond to similar immunosuppressive therapies and have similar prognoses.
p.10
Histopathology of Scleritis
What type of inflammatory infiltrate is seen in episcleritis?
A very mixed inflammatory cellular infiltrate with minimal mitotic figures.
p.5
Clinical Manifestations and Diagnosis
What are the characteristics of nodules in nodular scleritis?
Deep, red, totally immobile, and separate from overlying congested episcleral tissues.
p.18
Immune-Mediated Inflammatory Conditions
What ocular condition was reported by Bellhorn and Henkind (1967)?
Ocular nodular fasciitis in a dog.
p.3
Classification of Episcleritis and Scleritis
How can scleritis be further classified based on location?
Into anterior scleritis and posterior scleritis, which can be diffuse, nodular, necrotizing with inflammation, or necrotizing without inflammation.
p.5
Classification of Episcleritis and Scleritis
What is scleromalacia perforans?
A rare form of necrotizing scleritis without signs of pain or inflammation, often seen in rheumatoid arthritis.
p.7
Treatment Options for Episcleritis and Scleritis
What are the therapeutic goals of scleritis treatment?
Control of inflammation, elimination of pain, reduction of complications, and treatment of any underlying systemic disease.
p.17
Treatment Options for Episcleritis and Scleritis
What treatment options are discussed in the study by Carrasco et al. (2005)?
Therapeutic decisions in anterior scleritis.
p.15
Secondary Causes of Episcleritis and Scleritis
What are common causes of scleritis and episcleritis?
Intraocular surgery, ocular trauma, penetrating foreign bodies, and endophthalmitis.
p.16
Treatment Options for Episcleritis and Scleritis
What is the treatment response for most cases of episcleritis?
They respond to topical corticosteroid immunosuppression.
p.9
Clinical Manifestations and Diagnosis
What supports the diagnosis of immune-mediated episcleritis?
The mixed inflammatory infiltrate and a lack of detectable infectious organisms.
p.14
Secondary Causes of Episcleritis and Scleritis
What can cause unilateral and bilateral episcleritis?
Bacterial infections, parasitic infestations, subconjunctival foreign bodies, and traumatic injuries.
p.2
Pathogenesis and Anatomy of the Sclera
What is the primary function of the sclera?
Protection of the ocular contents and provision of anchorage for extraocular muscles, bulbar conjunctiva, and the optic nerve.
p.14
Clinical Manifestations and Diagnosis
What type of granulomas were noted in the fundus photograph of the affected dog?
Multiple focal choroidal granulomas.
p.17
Clinical Manifestations and Diagnosis
What is the significance of the study by Jabs et al. (2000)?
It discusses clinical features and treatment results of episcleritis and scleritis.
p.12
Pathogenesis and Anatomy of the Sclera
What is the assumed etiology of nonnecrotizing scleritis?
It is most often assumed to be immune-mediated.
p.17
Clinical Manifestations and Diagnosis
What is the focus of the study by Akpek et al. (2004)?
Evaluation of patients with scleritis for systemic disease.
p.9
Histopathology of Scleritis
What distinguishes nodular episclerokeratitis from focal and diffuse episcleritis in terms of cellular composition?
Nodular episclerokeratitis has significantly more fibroblasts and less histiocytes, lymphocytes, and plasma cells.
p.13
Histopathology of Scleritis
What findings confirm the diagnosis of necrotic scleritis upon microscopic examination?
Collagen necrosis, collagen lysis, and scleral and episcleral inflammation.
p.7
Prognosis and Complications
What is the significance of systemic disease in patients with scleritis?
It has been associated with increased mortality and may limit lifespan due to related conditions.
p.8
Clinical Manifestations and Diagnosis
What is required to confirm an etiologic diagnosis in cases of episcleritis?
Biopsies of the inflamed masses.
p.14
Secondary Causes of Episcleritis and Scleritis
In which regions are infections like E. canis and Onchocerca spp. more common?
Geographic regions where these organisms are prevalent.
p.18
Bilateral Nodular Episclerokeratitis in Collie-Type Dogs
What is the focus of the study by Dugan et al. (1993)?
Variant nodular granulomatous episclerokeratitis in four dogs.
p.6
Surgically Induced Scleritis
What is surgically induced necrotizing scleritis (SINS)?
A focal area of intense scleral inflammation that develops adjacent to the site of previous scleral or limbal incision.
p.2
Secondary Causes of Episcleritis and Scleritis
What secondary conditions can result from inflammation of the sclera and episclera?
Uveitis, conjunctivitis, and orbital cellulitis.
p.18
Secondary Causes of Episcleritis and Scleritis
What was the focus of the retrospective study by Komnenou et al. (2007)?
Ocular manifestations of natural canine monocytic ehrlichiosis (Ehrlichia canis).
p.2
Classification of Episcleritis and Scleritis
What are the classifications of episcleritis and scleritis according to Yanoff and Fine?
Episcleritis as simple or nodular; scleritis as anterior diffuse, anterior nodular, anterior necrotizing with and without inflammation, and posterior scleritis.
p.3
Pathogenesis and Anatomy of the Sclera
What is the significance of inflammation in the episclera and sclera?
They are frequently affected secondary to inflammation from adjacent structures like the conjunctiva, cornea, uvea, and orbit.
p.12
Classification of Episcleritis and Scleritis
What is a key difference between nonnecrotizing scleritis and necrotic scleritis?
Nonnecrotizing scleritis lacks collagen necrosis.
p.11
Histopathology of Scleritis
What is a common characteristic of proliferative lesions in episcleritis?
Cells that are nonreactive to histiocytic markers.
p.16
Prognosis and Complications
How does scleritis differ from episcleritis in terms of severity?
Scleritis is a malignant inflammatory condition that can induce uveitis and threaten vision.
p.17
Episcleritis and Scleritis in Dogs
What are the main conditions discussed in the provided references?
Episcleritis and scleritis.
p.5
Clinical Manifestations and Diagnosis
What are the clinical manifestations of necrotizing scleritis?
Severe vasculitis, capillary nonperfusion, infarction, and necrosis of the sclera.
p.7
Histopathology of Scleritis
What is the histological characteristic of infectious scleritis?
Necrotic sclera surrounded by microabscesses.
p.9
Clinical Manifestations and Diagnosis
How do the laboratory results of dogs with unilateral and bilateral episcleritis compare?
They were not significantly different.
p.15
Treatment Options for Episcleritis and Scleritis
How is onchocerciasis treated?
By debulking granulomas surgically and administering melarsomine (2.5 mg/kg every 24 hours) followed by ivermectin (50 µg/kg every 24 hours for 30 days).
p.17
Treatment Options for Episcleritis and Scleritis
What does the study by Davidson et al. (2007) address?
Management of severe scleral melt using a tarsoconjunctival pedicle flap.
p.9
Histopathology of Scleritis
What does the presence of vascular hyalinization indicate in nodular episclerokeratitis?
It is likely the effect of chronic inflammation, not associated with vasculitis or collagen vascular disorder.
p.13
Treatment Options for Episcleritis and Scleritis
What surgical intervention may be required for large staphyloma in necrotic scleritis?
Repair with scleral grafts.
p.12
Clinical Manifestations and Diagnosis
What is the primary characteristic of nonnecrotizing immune-mediated scleritis in dogs?
It manifests with a diffusely thickened sclera and conjunctival and episcleral hyperemia.
p.2
Clinical Manifestations and Diagnosis
What similarities have been identified in recent studies of episcleritis in dogs?
Similarities and differences in unilateral, bilateral, nodular, and diffuse forms.
p.18
Episcleritis and Scleritis in Dogs
What condition is addressed in the study by Peiffer et al. (1976)?
Proliferative episcleritis in dogs.
p.5
Clinical Manifestations and Diagnosis
What are the clinical manifestations of posterior scleritis?
Marked ocular pain, decreased vision, ocular proptosis, and fundus abnormalities.
p.16
Clinical Manifestations and Diagnosis
What are the common clinical manifestations of episcleritis?
Focal to diffuse hyperemia, congestion, and edema of the episclera, often near the limbus.
p.4
Clinical Manifestations and Diagnosis
How does diffuse episcleritis present clinically?
As ill-defined, intense redness and edema with engorged superficial episcleral vessels.
p.1
Clinical Manifestations and Diagnosis
What are common clinical manifestations of episcleritis and scleritis in dogs?
Corneal edema, degeneration, and conjunctival hyperemia and edema.
p.7
Clinical Manifestations and Diagnosis
What is a common misdiagnosis for unilateral or bilateral focal or diffuse episcleritis in dogs?
Nonresponsive conjunctivitis, uveitis, orbital cellulitis, and keratitis.
p.11
Treatment Options for Episcleritis and Scleritis
What is the typical treatment approach for recurrent bilateral episcleritis?
Lifelong or long-term therapies with topical corticosteroids and possibly oral immunosuppressants.
p.4
Clinical Manifestations and Diagnosis
How can scleritis be differentiated from episcleritis?
By maximal involvement of the deep episcleral vascular plexus, which is displaced outward in scleritis.
p.12
Clinical Manifestations and Diagnosis
How does nonnecrotizing scleritis differ from diffuse episcleritis?
It includes posterior uveitis and increased severity of inflammation.
p.17
Secondary Causes of Episcleritis and Scleritis
What is the focus of the study by Pavesio and Meier (2001)?
Systemic disorders associated with episcleritis and scleritis.
p.4
Episcleritis and Scleritis in Dogs
What is episcleritis?
Inflammation confined to the superficial episcleral tissue, usually mild and non–vision-threatening.
p.11
Treatment Options for Episcleritis and Scleritis
What are the preferred initial therapies for unilateral and bilateral episcleritis?
Topical immunosuppression with 1% prednisolone acetate or 0.1% dexamethasone solutions.
p.9
Histopathology of Scleritis
What types of cellular infiltrates are found in episcleritis?
Lymphocytes, plasma cells, macrophages, fibroblasts, and occasional neutrophils and giant cells.
p.7
Prognosis and Complications
How does systemic lupus erythematosus affect the prognosis of scleritis?
It tends to be a benign and self-limiting condition.
p.4
Treatment Options for Episcleritis and Scleritis
What are common treatments for episcleritis?
Topical nonsteroidal or steroidal anti-inflammatory medications for symptomatic relief.
p.13
Pathogenesis and Anatomy of the Sclera
What is the assumed etiology of necrotic scleritis in dogs?
Immune-mediated, based on similar diseases in humans.
p.8
Classification of Episcleritis and Scleritis
What is the recommended term to avoid confusion regarding bilateral nodular episclerokeratitis?
Nodular episclerokeratitis.
p.13
Clinical Manifestations and Diagnosis
What are common clinical manifestations of necrotic scleritis?
Markedly thickened and inflamed sclera, scleral lysis, staphyloma, conjunctivitis, episcleritis, choroiditis, and choroidal granulomas.
p.4
Prognosis and Complications
What is the typical onset of simple and nodular episcleritis?
Simple episcleritis usually subsides in 5 to 10 days, while nodular episcleritis may dissipate within 4 to 5 weeks.
p.1
Clinical Manifestations and Diagnosis
How can the clinical diagnosis of episcleritis and scleritis be established?
Through the observation of corneal edema and conjunctival hyperemia and edema.
p.4
Clinical Manifestations and Diagnosis
What is a characteristic feature of scleritis?
Severe pain that may radiate to the ear, scalp, face, and jaw.
p.16
Secondary Causes of Episcleritis and Scleritis
What are common secondary causes of episcleritis and scleritis?
Foreign body penetration, surgery, choroiditis, and conjunctivitis.
p.11
Treatment Options for Episcleritis and Scleritis
What additional therapies may be used for nodular episclerokeratitis?
Topical corticosteroids, azathioprine, intralesional corticosteroids, and surgical options.
p.15
Histopathology of Scleritis
What types of inflammatory cells are typically found in acute lesions of scleritis?
Neutrophils and macrophages.
p.7
Prognosis and Complications
What may occur in more severe cases of scleritis after inflammation subsides?
Affected portions of sclera may become thin and staphylomas may form.
p.8
Clinical Manifestations and Diagnosis
What are the clinical lesions of bilateral nodular episclerokeratitis in collie-type dogs?
Bilateral fleshy proliferative subepithelial temporal corneal limbal masses and hyperemic third eyelid thickening.
