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Pathology News
A Collaborative Approach to
Ocular Pathology - Simon Priestnall
Associate Professor of Veterinary Pathology Simon Priestnall, an RCVS & American Specialist in Veterinary Pathology, talks about the ocular pathology expertise at the RVC, which supports referred patients. The expertise can also be accessed directly by veterinary practices as part of the service offered by the RVC Pathology and Diagnostic Laboratories team.
Ocular pathology is a specialised branch of anatomic pathology and requires experience of
seeing many cases and a range of clinical conditions and disease entities. Many pathologists feel out of their depth with ocular pathology, but with time and experience it is a very rewarding and interesting discipline.
The RVC Ophthalmology Service,
led by Charlotte Dawson, receives many ocular samples, including whole eyes (enucleation) and, increasingly, samples of cornea, conjunctiva and even intraocular biopsies (e.g. lens). Having an in-house expert and specialist pathology service enables a rapid diagnosis for patients referred into the RVC’s hospitals, therefore clinical decisions can be made and necessary treatment started more quickly.
We hold monthly rounds in which
we discuss clinical cases seen at all
RVC referral services, sharing gross (macroscopic) pictures and ultrasound or intra-surgical images, in conjunction with the histopathology findings.These make for both a great discussion of
case management and work-up, and
are essential training for our anatomic pathology and ophthalmology residents.
My interest in ocular pathology has developed from a strong clinical and research collaboration with Dr Caroline Thaung, Consultant Ophthalmic Pathologist at Moorfields Eye Hospital
Above: Normal eye from a common hippopotamus, courtesy of Dr Alejandro Suárez-Bonnet, RVC
Below: Alpaca eye with severe diffuse necrosuppurative panophthalmitis, due to a penetrating injury to the cornea
Recent interesting cases we have shared expertise for include comparative pathology of ocular neoplasms (e.g. melanomas and squamous cell carcinomas) in humans and animals, retinal degeneration, glaucoma and cataract development.
One recent area of research in
which the RVC and Caroline’s team
have collaborated is in developing a classification and scoring scheme for feline idiopathic anterior uveitis.We presented this work as an abstract at the annual American College of Veterinary Pathologists meeting in New Orleans last December, and it has been submitted for publication in Veterinary Ophthalmology. This system enables, for the first time, the severity and distribution of the inflammation in uveitis to be assessed objectively and describes how idiopathic disease can be differentiated from that induced by feline infectious peritonitis.
More unusual cases we have examined are eyes from an aged common hippopotamus living at Whipsnade Zoo, an alpaca with severe panophthalmitis following a penetrating injury and lens rupture, and I am currently working with the University of Las Palmas de Gran Canaria’s Institute for Animal Heath and Food Security to examine and describe the histopathology of cetacean (whales and dolphin) eyes.
The RVC’s Diagnostic Pathology Service is keen to receive ocular samples as well as other surgical biopsy samples from practising veterinary surgeons,
which are essential for the training of
our anatomic pathology residents. Our turnaround time for all routine samples is 48 hours from receipt of the specimen into the laboratory, and the report contains a full ‘board-style’ histological description, diagnosis, and comment tailored specifically to the case. My colleagues and I are always keen to follow up cases over the phone or by email.
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and Honorary Senior Research Associate at University College London’s Institute of Ophthalmology. Caroline is a world expert in ocular pathology and enjoys sharing interesting veterinary cases.
She has an excellent blog (https://eyepathlondon.wordpress.com).
Issue: Spring
THE RVC FACILITIES:
n Outstanding diagnostic laboratory facilities at the RVC’s Hawkshead campus provide a range of world-class diagnostic pathology services, enabling you to provide better medicine and fast results to your clients.These diagnostic services are provided by pathologists and technicians with a vast experience of routine and more complex clinical cases. There are excellent links between the diagnostic team and our specialist clinical teams.
n RVC Diagnostic Laboratory Services can be contacted on 01707 666208 and via the email address rdouthwaite@rvc.ac.uk
rvc.ac.uk/clinical-connections
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