hed session gonioscopy - ecvo · hed session gonioscopy marianne richter ecvo congress, estoril...
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HED sessionGonioscopy
Marianne RichterECVO Congress, Estoril 2017
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HED committee:
• Proposal of a new grading system forgonioscopy (draft by M.Richter), presentedin Budapest 2016 (M.Richter, F.Stades)
• Collection of comments/ suggestions of all national panels: A, D, CH, I, F, B, S, N, DK, NL, FIN, GB (M.Richter)
M.Richter, Estoril 2017
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HED committee:
• Establishment of a gonioscopy sub-committee: B. Ekesten, P. Bedford, C. Bundgaard, G.Chaudieu, A. Guandalini, M. Richter
• Slides are kindly provided by B.Spiess
M.Richter, Estoril 2017
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ECVO Manual – present guidelines (2016)
• At Present: pectinate ligament abnormality (PLA) is classified as unaffected/undetermined/affected using the terms fibrae latae (FL)/laminae (LA)/occlusio(OC)
if affected by PLA, findings are judged as mild/moderate/severe, whereas LA and OC are to be judged as moderate or severe.
M.Richter, Estoril 2017
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ECVO Manual – present guidelines (2016)
1. Fibrae latae (FL): in which the normal part of the pectinate ligament fibre is too short and the abnormal part is broadened; also described as broad bands; 2. Laminae (LA): plates or sheets of continuous tissue, with very short remaining fibres in the angle;3. Occlusio (OC): pectinate ligament completely closed, with flow holes, and narrowed angle and/or shallow anterior chamber;
M.Richter, Estoril 2017
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ECVO Manual – present guidelines (2016)
• The severity of laminae (LA) or occlusio (OC) can never be less than moderate or severe.If occlusio is present > 25 % of the angle it is evaluated as: ‘severe’.
M.Richter, Estoril 2017
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Fibrae latae (FL): in which the normal part of the pectinate ligament fibre is too short and the abnormal part is broadened; also described as broad bands; Laminae (LA): plates or sheets of continuous tissue, with very short remaining fibresin the angle;Occlusio (OC): pectinate ligament completely closed, with flow holes, and narrowed angle and/or shallow anterior chamber;
FL/LA ?
LA/OC ?
Affected: moderate?
Affected: severe?
M.Richter, Estoril 2017
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Motivation to change evaluation of the iridocorneal angle (ICA):
• The present ECVO certificate does not differentiate extent (circumference) of PLA (focal vs extensive for LA and OC) and widthof ICA.
• From clinical observations the extent of PLA related to 360 angular degree of the ICA andthe width of the ICA seem to be important concerning the likelihood to develop glaucoma.
M.Richter, Estoril 2017
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Motivation to change evaluation of the iridocorneal angle (ICA):
• Breeders need advice about clinical significance (to develop glaucoma) and which dogs can be used for breeding
• Currently, dogs are selected for breeding by the terms affected FL/LA/OC but not by the clinically important aspect of the extent of involvement of the ICA (360 degrees)
M.Richter, Estoril 2017
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10
Aim of gonioscopy:
• Detection & Grading of abnormalities of the iridocorneal angle (ICA) by evaluation of pectinate ligament (PL) and iridocorneal angle width (ICAW)
• Identification/Selection of dogs with abnormalities of the ICA potentially leading to blindness (severely affected dogs should be excluded from breeding)
M.Richter, Estoril 2017
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NEW
Grading of the ICA (PL and ICAwidth):
• pectinate ligament (PL): normal – fibrae latae – laminae/occlusio
• iridocorneal angle width (ICAwidth): open – narrow – closed
M.Richter, Estoril 2017
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Present
• FL < 25% = unaffected
• FL 25-50% = undetermined
• FL > 50% = affected (mild)
• LA = affected (moderate/severe)
• OC ≤ 25% = affected (moderate)
• OC > 25% = affected (severe)
NEW
• 0 – 50% FL = unaffected
• undetermined
• >50-100% FL and/or < 25% LA/OC =affected (mild)
• 25-50% LA/OC = affected (moderate)
• > 50% LA/OC = affected (severe)
Grading of pectinate ligament (PL):
M.Richter, Estoril 2017
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Present
• FL < 25% = unaffected
• FL 25-50% = undetermined
• FL > 50% = affected (mild)
• LA = affected (moderate/severe)
• OC ≤ 25% = affected (moderate)
• OC > 25% = affected (severe)
NEW
• 0 – 50% FL = unaffected
• >50-100% FL and/or < 25% LA =affected (mild)
• 25-50% LA = affected (moderate)
• > 50% LA = affected (severe)
Grading of pectinate ligament (PL):
M.Richter, Estoril 2017
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NEW
• Open = normal• Narrow = affected (moderate)• Closed = affected (severe)
Grading of iridocorneal angle width (ICAwidth):
Modified from publication: «Correlation of morphologic features of theiridocorneal angle to intraocular pressure in Samoyeds» Ekesten B, Narfström K. Am J Vet Res, vol 52, no. 11, November 1991, p 1875-1878.
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Comparison between 2 distances:A = length of PLB = distance from the origin of thePL to the anterior surface of thecornea at the transection areaC = PupilD = IrisE = PL F = inner/deep pigment bandG = outer/superficial pigment bandH = corneal transection
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
B A
M.Richter, Estoril 2017
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NEW
Definitions:• Normal PL:
thin/filamentous fibresfrom iris base to its insertion at the cornea
• FL (fibrae latae) : fibreswith a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (<5 fibres)
M.Richter, Estoril 2017
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Definitions:
• LA (laminae): plates or sheets of continuous tissue (>5 fibres), with or without flow holes
NEW
M.Richter, Estoril 2017
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18
NEWDefinitions:
• iridocorneal angle width (ICAwidth):open – narrow – closed
B
B
B
B
A
A
A
A
M.Richter, Estoril 2017
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Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
B
B
A
A
M.Richter, Estoril 2017
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present:
Eye disease no. …………………………… mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
Advantage: the examiner clearly indicates the severity of ICA abnormality in its entirety and ist clinical impact; comprehensible to the breeder
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
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You can still use the present Certificate:
Eye disease no. …………8……………… mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
X
NEW Certificate:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
In the area above for descriptive comments, the examinerspecifies the type of ICA abnormality: PLA (pectinate ligamentabnormality and/or ICA (iridocorneal angle) width
X
X X
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Fig 81
PLA: 0-50% FL around 360° =unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 0-50% FL around 360° = unaffectedICAW: open
Fig 81
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
BA
M.Richter, Estoril 2017
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You can still use the present Certificate
Eye disease no. ……………………….... mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 72
FL
PLA: 0-50% FL around 360°=unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 0-50% FL around 360° = unaffectedICAW: open
Fig 72
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
B A
M.Richter, Estoril 2017
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Eye disease no. ………..……………….... mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 3
FL
FL
PLA: 0-50% FL around 360°=unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 0-50% FL around 360° = unaffectedICAW: open
Fig 3
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
BA
M.Richter, Estoril 2017
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NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
Eye disease no. …………….…………….. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
X
You can still use the present Certificate:
M.Richter, Estoril 2017
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Fig 56
FL
FLFL
PLA: 0-50% FL around 360°=unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
BA
PLA: 0-50% FL around 360°= unaffectedICAW: open
Fig 56
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………..……..……….. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 20
FL
FL/LA?
FL
PLA: >50-100% FL and/or <25% LA= affected – mild
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
BA
PLA: >50-100% FL and/or <25% LA= affected – mild
ICAW: open
Fig 20
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………8..……..…… mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
XX
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 57
FL
PLA: 0-50% FL around 360°= unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
BA
PLA: 0-50% FL around 360°= unaffectedICAW: open
Fig 57
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………..……..……….. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 84
FL
Comment: FL (< 5 fibers)
PLA: 0-50% FL around 360°=unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 0-50% FL around 360°= unaffectedICAW: open
AB
Fig 84
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………..……..……….. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
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Fig 41
FL
PLA: 0-50% FL around 360°=unaffected
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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B A
A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
Fig 41
PLA: 0-50% FL around 360°=unaffectedICAW: narrow = affected (moderate)? orICAW: open = unaffectedComment: check position of goniolens, “borderline” cases!
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. ………….8.……..…….. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
X X
Comment: check position of gonio lens !If ICA = open: tick “unaffected”If ICA = narrow: tick “affected – ICAW narrow”
Descriptive comments: ICAW = narrow
X
You can still use the present Certificate:
X
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X
X
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Fig 1
FLLA LA
PLA: 25-50% LA (around 360°) = affected – moderate
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 25-50% LA (around 360°) = affected – moderateICAW: open
Fig 1
AB
Comment: in areas of LA the ICAW maybe narrow… however, we judge 360 degrees!...according to PLA the gradingwould be «affected-moderate» anyway!
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………..8…….……. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
X
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Fig 31
LA
PLA: 25-50% LA = affected – moderate
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
LA
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: 25-50% LA (around 360°) = affected – moderateICAW: open
Fig 31
AB
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. ………….8……..….... mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
X
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Fig 58
PLA: >50% LA = affected –severe
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: >50% LA (around 360°) = affected – severeICAW: open
Fig 58
AB
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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Eye disease no. …………..8…………. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusio
X
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
X
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Fig 10
LA
PLA: >50% LA = affected –severe
Normal PL: thin fibres from iris base to its insertion at the cornea
FL : fibres with a confluent (broad) base and shortened thin insertions at the cornea or thick fibres (< 5 fibres)
LA: plates or sheets of continuous tissue, with or without flow holes
ICAW: open-narrow-closed
M.Richter, Estoril 2017
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Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
PLA: > 50% LA (around 360°) = affected – severeICAW: open Comment: ICAW = open but occluded by LA (note the difference between the terms “closed” and “occluded”); If PLA or ICAW is graded “affected-severe” its meaning is comprehensible to the breeder
BA
Fig 10
M.Richter, Estoril 2017
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Eye disease no. …………8.…………… .. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
X
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
B A
Fig 83
PLA: > 50% LA (around 360°) = affected – severeICAW: closed? or open but occluded by extensive LA? (see next page)
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
M.Richter, Estoril 2017
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B A
Fig 83
Terminology: closed narrow openRatio A/B: PL not visible A < 1/3 of B A ≥ 1/3 of B
BA
Fig 10
?
M.Richter, Estoril 2017
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A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
Authors interpretation: ICA occluded by a sheet of pigmented tissue spanning the angle from the base of the iris to the inner-pigmented band with one flow hole visible. >90% affected or grade 3.
“Progression of pectinate ligament dysplasia over time in two populations of Flat-Coated Retrievers” R.Pearl, D.Gould, B.SpiessVeterinary Ophthalmology, Vol18, Issue 1, p 6-12, Sep 2013
B A
M.Richter, Estoril 2017
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Eye disease no. …………8.…………… .. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
X
Comment: 2 opinions of 2 examiners but same result !1. PLA «affected» «severe»2. ICAW: «affected» «closed» ; PL not visible – no
judgement possible
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
XX
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Fig 36
A = length of PLB = distance from the origin of the PL to theanterior surface of the cornea
Authors interpretation: ICA occluded by a sheet of pigmented tissue spanning the angle from the base of the iris to the inner‐pigmented band with several flow holes visible. 70% affected or grade 2.
“Progression of pectinate ligament dysplasia over time in two populations of Flat-Coated Retrievers” R.Pearl, D.Gould, B.SpiessVeterinary Ophthalmology, Vol18, Issue 1, p 6-12, Sep 2013
M.Richter, Estoril 2017
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Eye disease no. …………8.…………… .. mild moderate severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Lig. Pectinate abnormality (onlyafter gonioscopy)
fibrae lataelaminaeocclusioX
X
You can still use the present Certificate:
M.Richter, Estoril 2017
NEW:narrow (= moderate)
Eye disease no. …………......…………… mild severe* ** *UNAFFECTED UNDETERMINED AFFECTED
8. Iridocorneal angle abnormality (ICAA):(only after gonioscopy)
mildmoderatesevere
8. ICAA: PLA
ICA (width) closed (= severe)
mildmoderatesevere
X X
X
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64
NEW (Chapter 8 Vet Advice):
• Gonioscopy every 3 years /at age 1, 4 & 7 (Chapter 7 Recommendations regarding age and frequency)
• Breeding advice (ICA = iridocorneal angle abnormality):– Mild-moderate: OPTIONAL (according to present scientific
information available: if these dogs are used, it isrecommended to breed these dogs to unaffected gradeddogs)
– Severe: NO BREEDING (+ risk to develop glaucoma)
M.Richter, Estoril 2017
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65
Advantage of the new grading:
• Grading on the certificate is morecomprehensible to the breeder (unaffected, affected mild/moderate/severe)
• Grading of abnormalitites of PL and ICAwidth(in the descriptive comment area)
• Clinically relevant grading (360 degrees)
M.Richter, Estoril 2017
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66
Many thanks
• to the gonioscopy subcommittee members:Björn Ekesten, Peter Bedford, Claus Bundgaard, Gilles Chaudieu, Adolfo Guandalini
• for the slides: Bernhard Spiess
M.Richter, Estoril 2017
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Eye disease no mild mod. severe
affect.
• 0 – 50% FL = unaffected• >50-100% FL and/or < 25% LA =
affected (mild)• 25-50% LA = affected (moderate)• > 50% LA = affected (severe)
VetZ on-line system
M.Richter, Estoril 2017