Pannus

Also know as superficial stromal keratitis, Ubbereiter’s syndrome.

Clinical Signs

Most affected dogs have corneal lesions.

There are 2 basic types of pannus

Most cases have a combination of the vascular and pigmentary forms. The more active the pannus is the more blood vessel reaction is present. Once the pannus has been treated the vascular reaction reduces but pigment usually remains.

Some cases also develop corneal lipidosis – cloudiness in the cornea. This may be the result of the corneal inflammation but also may develop from the topical corticosteroid therapy.

Many cases also involve the third eyelid; the pannus causes depigmentation of the third eyelid.

In rare cases we have seen erosion of the medial canthus.

Predisposing factors

1. Breed German Shepherds are by far the most commonly affected breed. It is unknown why German Shepherds are so predisposed. Other breeds affected are Greyhounds and Border Collies

2. Sunlight The pannus lesions are potentiated by UV light. Most pannus lesions become worse in summer, and then less severe in winter.

Diagnosis

Is usually straightforward based on the marked breed predisposition, and the clinical signs.

Treatment of Pannus

1. Strong corticosteroid drops are required to treat Pannus. Depending on the severity of the lesions, the frequency and strength of the drops may vary. Care must be taken when using cortisone drops on the eye. If something happens to the eye that causes an ulcer or an infection, the cortisone drops can make the problem worse. Unlike humans cortisone drops in dogs do NOT cause glaucoma or cataracts.

2. In severe cases cortisone injections onto the eye may be required. This treatment is only in dogs that are difficult to treat or in very severe cases.

3. In most cases we also use topical cyclosporin. We find this particularly useful in cases with pigmentary lesions, and also when the third eyelid is inflamed. In cases with severe pigmentary keratitis we have found that long term cyclosporin and cortisone may reduce the amount of the pigmentary keratitis. A minimum of 3 months of twice daily therapy is required.

4. Keeping the patient out of the sun will help reduce the severity of the lesions, and will reduce how much cortisone will be required to control the lesions.

Prognosis

Most cases can only be controlled rather than cured. Long term therapy is required. If treatment is stopped, the lesions will recur.