A Case of Feline Proliferative Eosinophilic Keratitis Treated by Topical Cyclosporine and Corticosteroids

고양이 증식성 호산구성 각막염에서 국소적인 사이클로스포린과 코르티코스테로이드 점안 1례

  • Ahn, Jeong-Taek (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Jeong, Man-Bok (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Kim, Se-Eun (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Park, Young-Woo (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Kim, Tae-Hyun (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Ahn, Jae-Sang (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Lee, So-Ra (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Lee, Chang-Woo (College of VeteriBK21 Program for Veterinary Science, Seoul National University) ;
  • Seo, Kang-Moon (College of VeteriBK21 Program for Veterinary Science, Seoul National University)
  • Accepted : 2010.12.08
  • Published : 2010.12.31

Abstract

A 6-year-old spayed female Persian cat presented with a 3-month history of recurrent ulcerative keratitis with noticeable opacification and vascularization of the right cornea. The lesion was nonresponsive to topical antibiotics and to nonsteroidal anti-inflammatory drugs. Ophthalmic examination showed signs of ocular discomfort, such as epiphora and blepharospasm, in the right eye. Biomicroscopic examination revealed an irregular, edematous, vascularized mass with pink to white tissue on the entire cornea and mild conjunctivitis. A tentative diagnosis of feline proliferative eosinophilic keratitis (FPEK) was made on the basis of clinical appearance. Cytologic examination of the cornea showed a mixture of numerous eosinophils and mast cells, which confirmed the original diagnosis of FPEK. The cat was treated with a topical antibiotic-corticosteroid combination, cyclosporine ointment, trifluridine eye drops, and oral Llysine. The clinical signs improved remarkably 18 days after the cat was first examined. The short-term use of corticosteroids and long-term use of cyclosporine and an anti-viral agent resolved the lesion without recurrence of the disease for 1 year.

6 년령 중성화 암컷 페르시안 고양이가 3개월동안 우안의 재발성 각막궤양, 각막혼탁, 각막 혈관화를 주증상으로 내원하였다. 병변은 그 기간동안 국소적인 항생제와 비스테로이드성 소염제 점안에 치료반응이 없었다. 우안에서 유루증, 안검경련과 같은 안구통증 증상이 확인되었다. 미세 틈새등 현미경 검사에서 우안의 각막 전체에 분홍색에서 흰색을 띄는 부종성의 불규칙한 덩어리와 미약한 결막염을 확인하였다. 임상증상을 통해 고양이 증식성 호산구성 각막염으로 잠정 진단하였다. 각막의 세포학적 검사결과에서 다수의 호산구와 비만세포가 관찰되어 잠정적으로 내렸던 진단을 확진하였다. 본 환자는 국소적인 항생-코르티코스테로이드 합제, 사이클로스포린 연고, 트리플루리딘 점안과 전신적인 L-lysine 의 경구투여로 치료하였다. 치료시작 18일 후 내원 시 병변은 눈에 띄게 호전되었다. 국소적인 코르티 코스테로이드와 사이클로스포린의 병용치료는 고양이 증식성 호산구성 각막염에 유용한 치료법으로 생각된다.

Keywords

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