正常狗和狗的眼表玫瑰式孟加拉染色，伴有角膜结膜炎：初步发现

Williams DL* and Griffiths A

Queen’s Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK

*通讯地址：Williams DL，剑桥大学兽医医学系女王兽医学院医院，剑桥大学剑桥大学，剑桥CB3 CB3 0ES，英国，电话：07939074682；电子邮件：dlw33@cam.ac.uk;doctordlwilliams@aol.com

日期：提交：18 October 2017;Approved:27 October 2017;Published:30 October 2017

如何引用本文：Williams DL, Griffiths A. Ocular surface Rose Bengal staining in normal dogs and dogs with Keratoconjunctivitis Sicca: Preliminary findings. Insights Vet Sci. 2017; 1: 042-046. DOI:10.29328/journal.ivs.1001005

版权许可证：©2017 Williams DL等。这是根据Creativ必威体育西汉姆联e Commons归因许可分发的开放访问文章，该文章允许在任何媒介中不受限制地使用，分发和复制，前提是适当地引用了原始作品。

狗的角膜结膜炎西卡（KCS）或干眼症是一种常见的不舒服且潜在的盲目疾病[1]，最常见于使用Schirmer Tear Test（STT）诊断出最常被诊断出，这是Otto Schirmer首次开发的，用于量化1903年人民的撕裂生产。[2]，并在1975年由Gelatt进行了修改以在狗中使用[3]。通常认为，泪液润湿的泪液产生小于15mm/min的泪液诊断犬KC。在人类患者中，STT被认为是一项不太有价值的测试，并且通过测量撕裂膜渗透压的测量到通过使用玫瑰孟加拉的生命染料染色来评估眼部表面病理学来评估眼部表面病理学，从而使用其他诊断方法。或Lissamine绿色污渍。1933年，Sjogren描述了KCS患者观察到的染色模式，他推测该染料染色正常，但已取代角膜上皮蹲[4]。Passmore在他的1955年评论[5]中继续了这一理论，直到Norn在1960年代的作品才改变为了考虑到Rose Bengal染成死亡和退化上皮细胞[6-8]。二十年后，Scheffer Tseng发现，染料在培养中染色了一系列健康细胞，使他询问健康的角膜细胞是否被染色，如果是这样，为什么没有染色健康的角膜。他的小组的工作[9]表明，染料确实对培养的角膜上皮进行了染色，实际上对迁移细胞有轻度毒性。鉴于牛血清蛋白和羧甲基纤维素阻断了这种染色，Tseng表明，眼表上的粘液做同样的事情，并且是KCS中粘液的缺乏，使得受影响的角膜有可能吸收斑点。 Whatever the mechanism of action, Rose Bengal is a widely used stain in human eyes with KCS and it seems only reasonable to investigate if it has a part to play in the diagnosis of tear film deficiency in the dog. Here we present preliminary findings on Rose Bengal staining of the ocular surface of dogs with normal tear production and eyes with aqueous tear film deficiency.

All dogs in the study were presented for assessment and treatment of ophthalmological conditions at the Queens’ Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge from September 2014 to June 2015. Following a full ophthalmological examination including direct and indirect ophthalmoscopy (Practitioner direct ophthalmoscope and Vantage indirect ophthalmoscope, both Keeler, Windsor UK), STTs were performed using one batch of tear strips (EagleVision, Monterey, California) and the value of tear strip wetting after one minute was recorded. After thirty minutes a Rose Bengal strip was used with one drop of topical 10% sterile saline to apply dye to the surface of each eye. Photographs were taken immediately using a Nikon Coolpix 4500 digital camera held at 10cm from the eye, so that the degree of staining could be assessed at a later date with assessors blinded to the clinical status of the dog. Staining was categorised by the scale shown in table 1. Analysis of images was undertaken by ten individuals who were shown the images with no signalment data and asked to rate each one according to the scale in table 1. Eight were final year veterinary students and two were adults in non-veterinary professions. None had any prior experience with Rose Bengal usage in either humans or animals.

该研究被剑桥大学兽医学系的伦理和福利委员会评估和接受。所有所有者都将其动物包含在研究中的全体知情同意书中。在人类中，罗斯孟加拉人曾引起某些患者的眼部刺激。在本研究中，在这种情况下，在这种情况下，在这种情况下可以缓解局部情况，但在任何涉及的动物中都没有注意到眼部刺激。

使用了十只成年犬（伯尔尼山狗（1），Lurcher（1），灵缇犬（2），拉布拉多（3），金猎犬（2），拳击手（1）），年龄在3至9岁之间作为对照人群。这些狗的STT结果正常（超过15mm/min，范围为15-22mm/min，平均值±标准偏差18.6±1.7），没有角膜病理学或眼部刺激的迹象。在10只对照狗的20眼中，没有用玫瑰孟加拉染色（所有观察者都给所有20只眼睛的分数）。

The KCS group comprised 20 adult dogs with 36 eyes with STT<15mm/min)) all diagnosed with to uni-ocular or bilateral KCS. Only eyes with KCS were included in the study. The breeds were West Highland White Terriers (6), Cavalier King Charles Spaniels (4), English Cocker Spaniel (3), American Bulldog (2), Lhasa Apso (2), Pug (1), Mastiff (1) and crossbreed (1). The ages of these animals ranged from 6 to 12 years, with a median of 8 years and a mean of 8.2 years.

在KCS组中，平均STT值为6.3±5.2mm/min（范围0-14mm/min），平均玫瑰孟加拉分数为3.05±3.3（范围0.9-5），平均十个独立得分手。每个图像的得分手之间的平均响应最高为1点，平均变化为0.8点，而观察者之间的分数之间的平均变化相关，最小R值为0.70，最大值为0.93。有干眼症的狗的眼表面染色如图1所示。

从图1中可以看出，结果的传播在最低的STT结果下似乎更广泛。因此，进行了进一步的分析，将小组分解为在5mm/min及以上以及下面的stt中的小组。对于低于5mm/min的STT值，分析显示中等负相关（Pearson的相关系数，R：-0.62，R2：0.39，P = 0.00013）。从图1中的图中可以理解，结果的传播出现5，r：-0.068（p <0.05不显着），而对于5或更高的人，r：-0.82，p = 0.000026）。样本量太小，无法检查是否发现不同品种或年龄组之间的玫瑰孟加拉染色显着差异，并且此类工作正在等待进一步的研究。

For human patients with dry eye the Schirmer tear test is generally considered not to be particularly valuable and because of this a number of other tests are used. In veterinary ophthalmology on the other hand the ease of use and simplicity of the STT has led to its widespread use in diagnosis canine KCS. Having said that the ocular pathology seen in canine dry eye may not perfectly correlate with tear wetting of the Schirmer tear test strip and other diagnostic tests may be valuable in addition to the STT. We have recently detailed changes in osmolarity of the tear film [10] which in the human patient are considered a key factor causing ocular surface pathology in aqueous deficiency dry eye. The Rose Bengal stain may be valuable in documenting this corneal and conjunctival pathology directly. Over the years of its use there has been some debate over exactly what Rose Bengal stains. It used to be thought that the dye bound to dead or devitalised cells but now the consensus is that the dye binds to tissue that is devoid of mucus covering [9,11]. Whatever the exact mechanism, the stain evaluates ocular surface pathology rather than merely tear production as does the STT. For that reason the Rose Bengal stain should be a valuable addition to the diagnostic tests used in canine dry eye. Overall there is a correlation between Rose Bengal staining and the ST result, as shown statistically above and in the graph in figure 2. The correlation however, is not perfect. No eyes with STT below 15mm/min had staining scores of zero and no dogs with STT above 15mm/min stained with Rose Bengal. However there were eyes with a low STT which still had mean scores of less than 3 and, to a lesser extent, dogs with STT values of between 5 and 10mm/min which showed some degree of staining, so the correlation is not exact.

这项研究存在潜在的局限性。评估了少数狗，因此我们在这项研究的标题中承认这是初步发现。我们从个人获得兽医眼科专家知识的个人中获得了染料染色评分，以模拟一般兽医实践中的情况，但是更严格的定量方法可能是对照片进行图像分析以确定染色的眼表染色百分比，如前所述，如前所述在治疗慢性犬角膜炎的研究中进行[12]。然而，这突出了图1中所示的两个图像的评估眼表染色的进一步问题。角膜污渍被点缀，定义确切的染色程度很难。图1b显示了没有角膜染色但具有实质结膜染色的kcs较差的眼睛。我们没有指示图像评估者是否将两个表面都包括在评估中，还是试图将染色强度包括在其最终分数中。同样，每个图像都显示了眼睛的一个视图，同时评估活着的患者的眼睛，在这些患者中可以更准确地评估整个眼表面。即使考虑到这些限制，评估者的结果也相似。

根据这项小型研究的发现，我们建议将玫瑰孟加拉染色用作评估眼球的有价值的额外技术，以评估眼球的眼睛。进一步评估大量伴有角膜结膜炎的狗的技术将是有价值的，因为对人类干眼的临床评估中使用的另一种重要的染料lissamine绿色可能会进行研究。