Sudden acquired retinal degeneration syndrome

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Sudden acquired retinal degeneration syndrome (SARDS) is a disease in dogs causing sudden blindness. It can occur in any breed, but female dogs may be predisposed.[1] Approximately 4000 cases are seen in the United States annually.[2]

Characteristics[edit]

Symptoms include sudden permanent blindness, but may occur more slowly over several days, weeks or months,[3] dilated pupils. Pupillary light reflexes are usually reduced but present; the slow phase mediated by melanopsin in retinal ganglion cells is retained. Other symptoms commonly seen are similar to those seen with Cushing's disease and include increased water consumption and urination, weight gain, confusion, restlessness, behavioral changes and lethargy. These symptoms may develop over a few months preceding the onset of SARDS.[4] Clinical signs and disease progression vary markedly among individual animals, depending on the number and type of hormones that are increased, the degree of hormone elevation, and the age of the dog.[5]

Some owners notice a more obvious "eye shine" in photographs due to the dilated pupils and retinal atrophy creating what is described as a "hyper-reflective tapetum".

Causes[edit]

The cause of SARDS is considered to be idiopathic and the veterinary community is divided as to its cause, but the disease possibly involves autoimmune disease, toxins, elevations in adrenal sex hormones[5] or Cushing's disease.[6] Despite similar symptoms and blood test results to Cushing's disease, evaluation of dogs with SARDS did not reveal any tumors in the pituitary or adrenal glands.[7]

However, endocrine testing (i.e., Canine Adrenal Panel at the University of Tennessee College of Veterinary Medicine Endocrinology Service)[8] often shows elevations in adrenal sex hormones.

Autoimmune disease as a cause has also been called into question because of a lack of antiretinal autoantibodies in dogs with SARDS in one study.[9]

Diagnosis[edit]

Examination with an ophthalmoscope will initially show no changes, but in a few months atrophy of the retina will resemble the appearance of progressive retinal atrophy. Pathologically, there is a loss of the rod and cone cells followed by degeneration of other layers of the retina. The retinal degeneration appears to be related to apoptosis of these cells.[10] SARDS must be distinguished from other causes of sudden blindness that have no visible pathology, including retrobulbar optic neuritis, a tumor at the optic chiasm, or other central nervous system diseases. Electroretinography is useful to definitively diagnose SARDS.[11]

Treatment[edit]

As of 2016, there is no effective treatment for SARDS.[12] Various immunosuppressive treatment regimens have been tried, but are not consistently effective.[12] Treatment regimens with adrenal steroids and thyroid hormones have been proposed, but as of 2016 no controlled, peer reviewed studies had investigated the effectiveness of such treatments.[12]

References[edit]

  1. ^ Cullen C, Grahn B (2002). "DIAGNOSTIC OPHTHALMOLOGY: What are your clinical diagnosis, lesion localization, and differential diagnoses?". Can Vet J. 43 (9): 729–30. PMC 339566Freely accessible. PMID 12240536. 
  2. ^ "Some blind dogs may get chance to see again". DVM. Advanstar Communications: 1S. July 2007. 
  3. ^ "Sudden Acquired Retinal Degeneration (SARD)". The Merck Veterinary Manual. 2006. Retrieved 2007-03-11. 
  4. ^ Ofri, Ron (2006). "Examination of the Blind Animal" (PDF). Proceedings of the 31st World Congress of the World Small Animal Veterinary Association. Retrieved 2007-03-11. 
  5. ^ a b Carter RT, Bentley E, Oliver JW, et al.: Elevations in adrenal sex hormones in canine sudden acquired retinal degeneration syndrome (SARDS) [abstract]. Proc Am Coll Vet Ophthalmol:9:40, 2003.
  6. ^ Gelatt, Kirk N. (ed.) (1999). Veterinary Ophthalmology (3rd ed.). Lippincott, Williams & Wilkins. ISBN 0-683-30076-8. 
  7. ^ Gilmour M, Cardenas M, Blaik M, Bahr R, McGinnis J (2006). "Evaluation of a comparative pathogenesis between cancer-associated retinopathy in humans and sudden acquired retinal degeneration syndrome in dogs via diagnostic imaging and western blot analysis". Am J Vet Res. 67 (5): 877–81. doi:10.2460/ajvr.67.5.877. PMID 16649924. 
  8. ^ http://www.vet.utk.edu/diagnostic/endocrinology/index.php
  9. ^ Keller R, Kania S, Hendrix D, Ward D, Abrams K (2006). "Evaluation of canine serum for the presence of antiretinal autoantibodies in sudden acquired retinal degeneration syndrome". Vet Ophthalmol. 9 (3): 195–200. doi:10.1111/j.1463-5224.2006.00466.x. PMID 16634935. 
  10. ^ Miller P, Galbreath E, Kehren J, Steinberg H, Dubielzig R (1998). "Photoreceptor cell death by apoptosis in dogs with sudden acquired retinal degeneration syndrome". Am J Vet Res. 59 (2): 149–52. PMID 9492927. 
  11. ^ Gilger, Brian C. (2006). "Diagnosis and Treatment of Ocular Fundus Disorders of Geriatric Dogs" (PDF). Proceedings of the North American Veterinary Conference. Archived from the original (PDF) on 2007-09-29. Retrieved 2007-03-11. 
  12. ^ a b c Komáromy, AM; Abrams, KL; Heckenlively, JR; Lundy, SK; Maggs, DJ; Leeth, CM; MohanKumar, PS; Petersen-Jones, SM; Serreze, DV; van der Woerdt, A (July 2016). "Sudden acquired retinal degeneration syndrome (SARDS) - a review and proposed strategies toward a better understanding of pathogenesis, early diagnosis, and therapy". Veterinary Ophthalmology. 19 (4): 319–31. doi:10.1111/vop.12291. PMID 26096588.