Etiologies of nontraumatic feline uveitis in the UK: A retrospective observational study of 72 cats

Abstract

Background: Uveitis is a common ophthalmic diagnosis in cats, that can lead to discomfort and loss of vision. Identification of nonidiopathic cases facilitates treatment and could reduce morbidity associated with this condition.

Aim: To evaluate etiologies of nontraumatic uveitis in the UK, to compare diagnostic features between idiopathic cases
and those with an established underlying etiology, and to investigate the association of clinical signs and abnormal diagnostic findings with a confirmed etiology.

Methods: Records of cats diagnosed with uveitis at a UK referral center between August 2009 and April 2018 were  retrospectively reviewed, excluding traumatic (and reflex) cases. Cases were categorized based on whether an underlying etiology had been established in cases with confirmed etiology, idiopathic, and inconclusive cases. All cases had a minimum of 12-month follow-up unless an underlying etiology had been established. Population characteristics, clinical signs, diagnostic investigation features, and results were reported.

Results: 72 cases of uveitis were included, of which male cats and domestic breeds were overrepresented. An underlying etiology was determined in 23.6% of cases: 9.7% had infectious diseases, 5.6% had systemic neoplasia, 4.2%  had primary ocular neoplasia, and 4.2% had metabolic disease. Idiopathic uveitis comprised 37.5% of cases, and the remaining 38.9% were inconclusive, of which 35.7% died or were euthanased within the follow-up period. Among the study population, no significant age difference was found between cats with idiopathic disease or confirmed etiology. The unilateral disease was reported in 56.9% of cases and was not different across the idiopathic cases and confirmed etiology groups. The most common ophthalmic clinical sign was an aqueous flare, followed by keratic precipitates and hypotony. Iris color change (p = 0.015) and the presence of an intraocular mass (p = 0.025) were associated with an underlying etiology.

Conclusion: Idiopathic uveitis was found to be the most common diagnosis in this study  population. However, a similar proportion of cases had possible underlying etiologies as a high proportion manifested  systemic disease within the follow-up time. An underlying etiology could be established only in a quarter of cases.  Further studies are required to standardize the investigations required when assessing cats with uveitis to minimize  patient morbidity.