{"id":8099,"date":"2024-12-27T11:13:36","date_gmt":"2024-12-27T10:13:36","guid":{"rendered":"https:\/\/veterinarska-stanica-journal.hr\/?post_type=article&#038;p=8099"},"modified":"2024-12-27T11:13:36","modified_gmt":"2024-12-27T10:13:36","slug":"cytological-characteristics-of-the-eye-conjunctiva-in-dogs-with-atopic-dermatitis","status":"publish","type":"article","link":"https:\/\/journal.h3s.org\/?article=cytological-characteristics-of-the-eye-conjunctiva-in-dogs-with-atopic-dermatitis","title":{"rendered":"Cytological Characteristics of the Eye Conjunctiva in Dogs with Atopic Dermatitis"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/TajnaKOVAC-2024.jpg\" alt=\"\" width=\"194\" height=\"242\" class=\"alignright size-full wp-image-8100\" \/><\/p>\n<p style=\"text-align: center;\">T. <strong>Kova\u010d<\/strong>*, N. <strong>Lemo<\/strong>, N. <strong>Puva\u010da<\/strong> and L. <strong>Medven Zagradi\u0161nik<\/strong><\/p>\n<hr \/>\n<div class=\"autorinfo\"><strong>Tajna KOVA\u010c<\/strong>*, DVM, PhD student at Doctoral Studies In Veterinary Sciences, (Corresponding author, e-mail: tkovac@vef.hr), <strong>Nik\u0161a LEMO<\/strong>, DVM, PhD, Full Professor, <strong>Nejra PUVA\u010cA<\/strong>, DVM, <strong>Lidija MEDVEN ZAGRADI\u0160NIK<\/strong>, DVM, PhD, Assistant Professor, Faculty of Veterinary Medicine of University of Zagreb, Croatia<\/div>\n<div class=\"doi\"><a href=\"https:\/\/veterinarska-stanica-journal.hr\/pdf\/56\/56-3\/cytological-characteristics-of-the-eye-conjunctiva-in-dogs-with-atopic-dermatitis.pdf\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2021\/03\/pdf.png\" alt=\"\" width=\"32\" height=\"18\" class=\"alignleft size-full wp-image-1504\" \/><\/a><a href=\"https:\/\/doi.org\/10.46419\/vs.56.3.9\" target=\"_blank\">https:\/\/doi.org\/10.46419\/vs.56.3.9<\/a><\/div>\n<\/p>\n<p><a name=\"menu\"><\/a><\/p>\n<div id=\"menu\">\n<div class=\"block grey mid\"><span class=\"small\"><a class=\"btn\" href=\"#Abstract\">Abstract<\/a><a class=\"btn\" href=\"#Introduction\">Introduction<\/a><a class=\"btn\" href=\"#Materials\">Materials and methods<\/a><a class=\"btn\" href=\"#Results\">Results<\/a><a class=\"btn\" href=\"#Discussion\">Discussion<\/a><a class=\"btn\" href=\"#Conclusion\">Conclusion<\/a><a class=\"btn\" href=\"#Literatura1\" onclick=\"toggle_visibility('Literatura');\">References<\/a><a class=\"btn\" href=\"#Sazetak\">Sa\u017eetak<\/a><\/span><\/div>\n<\/div>\n<p><a name=\"Abstract\"><\/a><a class=\"alignright\" href=\"#\" onclick=\"scrollToTop();return false\"> &#9650;<\/a><\/p>\n<blockquote>\n<h2>Abstract<\/h2>\n<hr \/>\n<p>Atopic dermatitis is a chronic, pruritic inflammatory skin disease affecting approximately 10% of dogs worldwide. The disease typically manifests at an early age, causing pruritus and secondary skin lesions in specific anatomical regions. The pathophysiology of canine atopic dermatitis (CAD) remains incompletely understood, but recent research suggests a complex interplay between skin barrier dysfunction, allergic sensitisation, and microbial dysbiosis. Despite the well-established association between atopic dermatitis and conjunctivitis, the prevalence of conjunctivitis in dogs with CAD is often underestimated in clinical practice due to inadequate recognition of symptoms and a lack of specific diagnostic protocols. This study aimed to analyse the cytological characteristics of the conjunctiva in dogs affected by atopic dermatitis.<br \/>\nSamples were collected from 24 dogs diagnosed with CAD and treated at the University Veterinary Hospital, Faculty of Veterinary Medicine, University of Zagreb. Cytological analysis was performed on samples obtained using a cytobrush. The results revealed the presence of inflammatory cells in all samples, with lymphocytes most prevalent (87.5%). A mild degree of conjunctival metaplasia was observed in all dogs, regardless of the type of inflammatory cells and the severity of conjunctivitis. These findings suggest that atopic dermatitis may induce changes in the conjunctiva that are not necessarily correlated with the intensity of the inflammatory response. The presence of lymphocytes, along with eosinophils in some cases, underscores the diagnostic value of conjunctival cytology in dogs with CAD. Furthermore, the increased density of goblet cells suggests similarities in the pathophysiology of ocular allergies in dogs and humans, opening avenues for further research to better understand and treat these conditions.<br \/>\nThis study highlights the importance of an interdisciplinary approach in the diagnosis and treatment of atopic dermatitis, including regular ophthalmologic examinations as part of standard clinical practice.<\/p>\n<p><strong>Key words:<\/strong> <em>atopic dermatitis; allergic conjunctivitis; cytological analysis; dogs<\/em><\/p><\/blockquote>\n<p><a name=\"Introduction\"><\/a><a class=\"alignright\" href=\"#menu\"> &#9650;<\/a><\/p>\n<h2>Introduction<\/h2>\n<hr \/>\n<p>Until 2023, atopic dermatitis (AD) was defined as a chronic and pruritic inflammation of the skin, genetically predisposed, occurring as a result of the immune system\u2019s hypersensitivity to environmental substances. Atopic dermatitis is a very common allergic dermatosis in dogs, affecting approximately 10% (3\u201315%) of the global canine population.<br \/>\nThe disease typically manifests in dogs between 6 months and 3 years of age, with pruritus and secondary skin lesions resulting from the inflammatory process.<br \/>\nPruritus and characteristic secondary skin lesions appear on the face (eyes and mouth), ears, ventral neck and abdomen, axillary and inguinal regions, interdigital spaces, perineal area, and limb joints. The pathophysiology of canine atopic dermatitis (CAD) is still not fully understood (Olivry <em>et al<\/em>., 2015).<\/p>\n<p>Based on new research into the pathogenesis of canine atopic dermatitis, in 2023, the International Committee for Allergic Diseases in Animals (ICADA) published a new definition of CAD: \u201cCanine atopic dermatitis is an inherited, typically pruritic, and predominantly T-cell inflammatory skin disease involving interactions between skin barrier dysfunction, allergen sensitisation, and microbial dysbiosis.\u201d This new definition is valuable as it encompasses a broader understanding of the disease\u2019s pathogenesis (Eisenschenk <em>et al<\/em>., 2024).<\/p>\n<p>Conjunctivitis in dogs with atopic dermatitis has been described in the literature, but its prevalence is rarely observed in clinical practice. Although relevant reports and studies document this pathology, its true incidence appears to be underestimated. This may be due to inadequate recognition of clinical signs and a lack of specific diagnostic criteria within veterinary practice. The clinical presentation of conjunctivitis in allergic dogs can be ambiguous or masked by symptoms of other ophthalmic diseases, further complicating accurate diagnosis.<br \/>\nTherefore, raising awareness among veterinarians about this possibility is crucial, as is the development and implementation of more precise diagnostic protocols that enable etiological diagnosis and optimal treatment. The clinical symptoms of allergic conjunctivitis in dogs include periocular erythema and pruritus, conjunctival hyperaemia, chemosis, and increased tear production and\/or the presence of serous to mucous discharge (Almeida, 2012).<\/p>\n<p>Allergic conjunctivitis typically involves a type I hypersensitivity reaction affecting the eyelids, conjunctiva, and\/or cornea. Ocular allergies generally consist of three phases: the sensitization phase, early phase, and late phase. The sensitisation phase begins with exposure of the ocular surface to allergens and is asymptomatic. Dendritic cells in the conjunctiva phagocytise the allergens and differentiate into T-helper (Th) cells, predominantly Th2. Cytokines released by Th2 cells stimulate B cells to produce IgE antibodies, promote mast cell development, accumulate eosinophils, and lead to mucus hyperproduction. Mast cells and basophils possess high-affinity IgE receptors.<br \/>\nPruritus, conjunctival hyperaemia, and chemosis characterise the early phase and are triggered by inflammatory mediators, particularly histamine. Mast cells produce platelet-activating factors and cytokines that enhance vascular permeability, induce vasodilation, and promote chemotaxis and activation of neutrophils, eosinophils, and other inflammatory cells, leading to the late phase. The late phase is characterised by T lymphocyte activation through the production of Th2 cytokines and infiltration of the conjunctiva by eosinophils, neutrophils, and basophils (Varandas <em>et al<\/em>., 2020). The diagnosis of allergic conjunctivitis is based on a clinical ophthalmological examination conducted by a specialist who determines the type of conjunctivitis based on anamnesis and clinical signs. Exfoliative cytology of the cornea and conjunctiva is an ancillary diagnostic method for anterior segment eye diseases. The most commonly used techniques for obtaining conjunctival samples in dogs include the use of ophthalmic spatulas, blades, cotton swabs or cytology brushes (<em>Cytobrush<\/em>). Sampling with a cytology brush has proven to be a reliable (providing adequate cellularity) and non-invasive method. The presence of even a single eosinophil indicates allergic conjunctivitis. Additionally, plasma cells and lymphocytes are common findings in this diagnosis (Hendrix, 2013). These cells are absent in conjunctival smears of healthy dogs (Athanasiou <em>et al<\/em>., 2018). The aim of this study was to analyse the cytological characteristics of the conjunctiva in dogs affected by atopic dermatitis.<\/p>\n<p><a name=\"Materials\"><\/a><a class=\"alignright\" href=\"#menu\"> &#9650;<\/a><\/p>\n<h2>Materials and methods<\/h2>\n<hr \/>\n<p>The subjects of this study were patients from the University Veterinary Hospital at the Faculty of Veterinary Medicine, University of Zagreb, diagnosed with atopic dermatitis. The study included 24 dogs treated at the request of their owners. For the purpose of this study, conjunctival swab samples from dogs were collected during a non-experimental clinical investigation for diagnostic purposes as part of the patients\u2019 clinical evaluation (Figure 1). All procedures were conducted in accordance with the ethical approval obtained from the Ethics Committee of the Faculty of Veterinary Medicine (Class: 640-01\/21-02\/03, Reg. No.: 251-61-01\/139-21-37, February 26, 2021), granted at the 5th regular session of the Faculty Council in the academic year 2020\/21, held on 24 February 2021.<\/p>\n<p>The study included dogs diagnosed with atopic dermatitis, which had negative results from an elimination diet, were properly treated for endo- and ectoparasites, and had the consent of their owners to participate in the clinical study. Exclusion criteria were the administration of systemic anti-inflammatory drugs within the past month and\/or local ophthalmological treatments within the past 7 days.<\/p>\n<p>Each patient underwent a specialized dermatological and ophthalmological examination, followed by cytological analysis of the conjunctiva. The degree of conjunctivitis was determined for all dogs, and conjunctival swabs were taken using a cytology brush under local anaesthesia. After air drying, cytological samples were stained with May-Gr\u00fcnwald Giemsa for 2 minutes. After rinsing with distilled water, a filtered Giemsa solution diluted with distilled water at a 1:10 ratio was applied to the slides for 20 minutes. The slides were then rinsed with distilled water and air-dried.<\/p>\n<p>For the analysis of cytological samples, a Nikon 2000 Eclipse light microscope with 4x, 10x, 20x, and 40x objectives was used. Microphotographs were taken using an Olympus DP20 camera and the Cell B software (<em>Olympus<\/em>). The slides from the left and right conjunctiva were examined separately by a veterinary pathologist, though grading was based on the combined findings from both conjunctivae. Inflammatory cells were counted across the entire slide. The presence of 1\u20133 plasma cells or lymphocytes in the slides was classified as grade I, 3\u20136 cells as grade II, and more than 6 cells as grade III. The presence of a single neutrophil, eosinophil, or mast cell was classified as grade I, 2\u20133 as grade II, and more than 3 as grade III. In each slide, five fields of view with the highest cellularity were selected, where goblet cells were counted, and the degree of squamous metaplasia was determined.<\/p>\n<p>The degree of metaplasia (0\u20133) was determined based on cell shape (small, slightly enlarged, enlarged, large), cohesion (strong, some losses, disrupted, isolated cells), nuclear appearance (large and uniform, reduced, small and condensed, pyknotic\/absent), cytoplasmic staining (dark, light, variable, pale), and the nucleus-to-cytoplasm ratio (1:2, 1:3, 1:4\u20131:5, 1:6 or smaller).<\/p>\n<p><a name=\"Results\"><\/a><a class=\"alignright\" href=\"#menu\"> &#9650;<\/a><\/p>\n<h2>Results<\/h2>\n<hr \/>\n<p>The study population consisted of more males (15) than females (9). The average age (mean) was 5 years, with a median age of 4 years. The most represented breed was mixed breed (33.33%), while among purebred dogs, Parson Russell Terriers (3) and French Bulldogs (3) were the most common. Only one dog showed no clinical signs of allergic conjunctivitis; however, inflammatory cells were found in the cytological analysis of conjunctival swabs in all 24 dogs. The most common type of cell observed was lymphocytes, which were present in 21 samples (87.5%). <\/p>\n<figure id=\"attachment_8104\" aria-describedby=\"caption-attachment-8104\" style=\"width: 654px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Table01-Cytological.png\" alt=\"Table01-Cytological\" width=\"654\" height=\"723\" class=\"size-full wp-image-8104\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Table01-Cytological.png 654w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Table01-Cytological-271x300.png 271w\" sizes=\"auto, (max-width: 654px) 100vw, 654px\" \/><figcaption id=\"caption-attachment-8104\" class=\"wp-caption-text\"><strong>Table 1<\/strong>. Results of the cytological analysis of conjunctival swabs in 24 dogs diagnosed with atopic dermatitis.<\/figcaption><\/figure>\n<figure id=\"attachment_8105\" aria-describedby=\"caption-attachment-8105\" style=\"width: 462px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Figure01-Cytological.webp\" alt=\"Figure01-Cytological\" width=\"462\" height=\"378\" class=\"size-full wp-image-8105\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure01-Cytological.webp 462w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure01-Cytological-300x245.webp 300w\" sizes=\"auto, (max-width: 462px) 100vw, 462px\" \/><figcaption id=\"caption-attachment-8105\" class=\"wp-caption-text\"><strong>Figure 1<\/strong>. Collection of the conjunctival swab using a <em>cytobrush<\/em>.<\/figcaption><\/figure>\n<figure id=\"attachment_8106\" aria-describedby=\"caption-attachment-8106\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Figure02-Cytological.webp\" alt=\"Figure02-Cytological\" width=\"460\" height=\"345\" class=\"size-full wp-image-8106\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure02-Cytological.webp 460w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure02-Cytological-300x225.webp 300w\" sizes=\"auto, (max-width: 460px) 100vw, 460px\" \/><figcaption id=\"caption-attachment-8106\" class=\"wp-caption-text\"><strong>Figure 2<\/strong>. Eosinophil (indicated by arrow) in the cytological findings of the conjunctiva.<br \/>Magnification 40x.<\/figcaption><\/figure>\n<figure id=\"attachment_8107\" aria-describedby=\"caption-attachment-8107\" style=\"width: 428px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Figure03-Cytological.webp\" alt=\"Figure03-Cytological\" width=\"428\" height=\"321\" class=\"size-full wp-image-8107\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure03-Cytological.webp 428w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure03-Cytological-300x225.webp 300w\" sizes=\"auto, (max-width: 428px) 100vw, 428px\" \/><figcaption id=\"caption-attachment-8107\" class=\"wp-caption-text\"><strong>Figure 3<\/strong>. Density of goblet cells (indicated by arrow) in the cytological findings of the conjunctiva.<br \/>Magnification 40x.<\/figcaption><\/figure>\n<figure id=\"attachment_8108\" aria-describedby=\"caption-attachment-8108\" style=\"width: 528px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Figure04-Cytological.webp\" alt=\"Figure04-Cytological\" width=\"528\" height=\"388\" class=\"size-full wp-image-8108\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure04-Cytological.webp 528w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure04-Cytological-300x220.webp 300w\" sizes=\"auto, (max-width: 528px) 100vw, 528px\" \/><figcaption id=\"caption-attachment-8108\" class=\"wp-caption-text\"><strong>Figure 4<\/strong>. Plasma cells (indicated by arrow) in the cytological findings of the conjunctiva.<br \/>Magnification 40x.<\/figcaption><\/figure>\n<figure id=\"attachment_8109\" aria-describedby=\"caption-attachment-8109\" style=\"width: 485px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/veterinarska-stanica-journal.hr\/wp-content\/uploads\/2024\/12\/Figure05-Cytological.webp\" alt=\"Figure05-Cytological\" width=\"485\" height=\"364\" class=\"size-full wp-image-8109\" srcset=\"https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure05-Cytological.webp 485w, https:\/\/journal.h3s.org\/wp-content\/uploads\/2024\/12\/Figure05-Cytological-300x225.webp 300w\" sizes=\"auto, (max-width: 485px) 100vw, 485px\" \/><figcaption id=\"caption-attachment-8109\" class=\"wp-caption-text\"><strong>Figure 5<\/strong>. Lymphocytes (indicated by arrow) in the cytological findings of the conjunctiva.<br \/>Magnification 40x.<\/figcaption><\/figure>\n<p><a name=\"Discussion\"><\/a><a class=\"alignright\" href=\"#menu\"> &#9650;<\/a><\/p>\n<h2>Discussion<\/h2>\n<hr \/>\n<p>Cytological analysis of conjunctival samples in dogs is employed for the diagnosis and treatment of ophthalmic diseases. This method enables the rapid, cost-effective, and accurate identification of inflammatory and pathological changes in the eyes, which is crucial for determining the underlying cause of symptoms and selecting the appropriate therapy. It is most commonly used when neoplasms are suspected (e.g., melanoma). Additionally, it serves as a valuable tool in the diagnosis of infectious diseases (bacteria, viruses, fungi, and parasites).<br \/>\nIn such cases, cytology is often used in conjunction with other diagnostic methods, such as bacterial culture or parasite testing. Unlike in horses, the cytology of healthy canine conjunctiva has not been extensively described or correlated with histology. Research indicates that conjunctival cytology in dogs reveals layers of epithelial cells, including basal, intermediate, and superficial cells. Superficial and intermediate cells often contain brown cytoplasmic melanin granules.<br \/>\nIn some samples, goblet cells and keratinised cells have been identified, while neutrophils, lymphocytes, and monocytes are present in smaller numbers. Due to the limited knowledge regarding the cytology of healthy canine conjunctiva, conjunctival cytology is not yet routinely performed in the diagnosis of ophthalmic diseases (Athanasiou <em>et al<\/em>., 2018; Trumel <em>et al<\/em>., 2020).<\/p>\n<p>Moreover, in human medicine, despite a greater number of studies than in veterinary medicine, conjunctival cytology is not routinely used in the diagnosis of allergic conjunctivitis. Symptoms of allergic conjunctivitis often overlap with those of other ophthalmic conditions (e.g., dry eye syndrome), necessitating the introduction of new diagnostic procedures to ensure more accurate diagnoses and treatments. Cytological examination of conjunctival samples is certainly one of these procedures (Kari <em>et al<\/em>., 2010; Leonardi <em>et al<\/em>., 2015; Bielory <em>et al<\/em>., 2020).<\/p>\n<p>Conjunctivitis without other ocular symptoms is most often of non-infectious aetiology, commonly caused by allergies, dryness, or mechanical irritation. Primary bacterial conjunctivitis is extremely rare in dogs. In cytological preparations for this diagnosis, numerous neutrophils are visible alongside bacterial findings.<br \/>\nBacterial conjunctivitis is usually sec ondary to eyelid pathology, dry eye syndrome, or trauma (Furiani <em>et al<\/em>., 2011; Hendrix, 2013). Among non-infectious causes of conjunctivitis in dogs, allergic conjunctivitis often occurs as part of atopic dermatitis, although it may also present as an isolated manifestation (Louren\u00e7o-Martins <em>et al<\/em>., 2011; Almeida, 2012). The cited studies suggest that, in addition to dermatological examination, every dog diagnosed with atopic dermatitis should also undergo an ophthalmological examination. Our results corroborate this and confirm the importance of an interdisciplinary approach in the diagnosis and treatment of atopic dermatitis in dogs. Cytological preparations frequently reveal eosinophils and lymphocytes, which represent a specific cytological finding. The presence of even a single eosinophil is considered diagnostic (Hendrix, 2013). In the present study, lymphocytes were the most commonly observed inflammatory cells, consistent with the literature. Furiani <em>et al<\/em>. (2011) found a significant increase in the number of epithelial cells, particularly keratinised epithelial cells, likely due to squamous metaplasia in allergic dogs. In this study, all cytological samples from dogs with atopic dermatitis exhibited a mild degree of metaplasia, regardless of the presence or type of inflammatory cells. These results suggest that atopic dermatitis in dogs may induce changes in conjunctival cells that are not necessarily related to the intensity or type of inflammatory response.<\/p>\n<p>Follicular conjunctivitis occurs as a result of chronic antigenic stimulation without evidence of infectious disease.<br \/>\nConjunctivitis may also be associated with inadequate tear production, and there are variations in the literature regarding the cytological characteristics of dry eye (<em>keratoconjunctivitis sicca<\/em> &#8211; KCS). Scrapes from the ocular mucosa of dogs with chronic untreated KCS are characterised by increased amounts of mucus, goblet cells, and keratinization, while conjunctival samples from dogs with acute KCS reveal bacteria, neutrophils, mucus, and debris. Cytology of the bulbar or palpebral conjunctiva in dogs with immune-mediated KCS confirmed squamous metaplasia with keratinization and possible infiltration of inflammatory cells, predominantly neutrophils, but goblet cells were not present (Bolzan <em>et al<\/em>., 2005). In human medicine, research has highlighted the key role of conjunctival goblet cells as the primary source of mucus for the ocular surface, in the development of ocular allergies. It has been observed that allergic mediators such as histamine, leukotrienes, and prostaglandins directly stimulate mucus secretion from goblet cells and increase their proliferation (Leonardi <em>et al<\/em>., 2008; Doughty, 2012; Dartt and Masli, 2014). In the present study, all dogs exhibited an increased density of goblet cells, indicating similar a mechanism of action of allergic mediators as in humans. It would be interesting to conduct a study that includes tear film measurement (Schirmer tear test) and cytological analysis of goblet cells to better understand these processes. In allergic humans (Dartt and Masli, 2014; Hisey <em>et al<\/em>., 2023) a predisposition to dry eye syndrome is known. In dogs, dry eye syndrome is considered immune-mediated (Ofri <em>et al<\/em>., 2024), though further research is needed to explore the connection with atopic dermatitis in order to develop adequate therapeutic strategies.<br \/>\nThese findings lay the groundwork for future research aimed at enhancing the diagnosis and treatment strategies for these conditions in dogs.<\/p>\n<p><a name=\"Conclusion\"><\/a><a class=\"alignright\" href=\"#menu\"> &#9650;<\/a><\/p>\n<h2>Conclusion<\/h2>\n<hr \/>\n<p>This study confirmed the association between canine atopic dermatitis and inflammatory changes in the conjunctiva, as analysed through cytological methods.<br \/>\nAll 24 dogs included in the study presented with inflammatory cells in conjunctival cytological samples. Although eosinophils are typically associated with allergic reactions, lymphocytes were the most prevalent cell type in this investigation. These findings underscore the need for further research involving a larger cohort of dogs, along with additional ophthalmologic evaluations, such as tear film measurement. Based on the obtained data, it can be concluded that an interdisciplinary approach is necessary for the diagnosis and treatment of canine atopic dermatitis, incorporating ophthalmologic examinations and conjunctival cytology as standard components of the clinical protocol.<\/p>\n<p><a name=\"Literatura1\"><\/a><br \/>\n<strong>References<\/strong><span style=\"color: #808080;\"><a onclick=\"toggle_visibility('Literatura');\" ><span style=\"color: #808080; cursor:pointer;\"> [&#8230; show]<\/span><\/a><\/span><\/p>\n<div id=\"Literatura\" style=\"display: none;\">&nbsp;<a class=\"alignright\" href=\"#menu\" onclick=\"toggle_visibility('Literatura');\"> &#9650;<\/a><\/p>\n<p style=\"font-size: small;\"><em>1.\tALMEIDA, O. C. 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MASLI (2014): Conjunctival epithelial and goblet cell function in chronic inflammation and ocular allergic inflammation. Curr. Opin. Allergy Clin. Immunol. 14, 464-470. 10.1097\/ACI.0000000000000098.<br \/>\n6.\tDOUGHTY, M. J. (2012): Goblet Cells of the Normal Human Bulbar Conjunctiva and Their Assessment by Impression Cytology Sampling. Ocul. Surf. 10, 149-169. 10.1016\/J.JTOS.2012.05.001.<br \/>\n7.\tEISENSCHENK, M. C., P. HENSEL, M. N. SARIDOMICHELAKIS, C. TAMAMOTO-MOCHIZUKI, C. M. PUCHEU-HASTON and D. SANTORO (2024): Introduction to the ICADA 2023 canine atopic dermatitis pathogenesis review articles and updated definition. Vet. Dermatol. 35, 3-4. 10.1111\/vde.13183.<br \/>\n8.\tFURIANI, N., F. SCARAMPELLA, P. A. MARTINO, I. PANZINI, E. FABBRI and L. ORDEIX (2011): Evaluation of the bacterial microflora of the conjunctival sac of healthy dogs and dogs with atopic dermatitis. Vet. Dermatol. 22, 490-496. 10.1111\/J.1365-3164.2011.00979.X.<br \/>\n9.\tHENDRIX, D. V. H. (2013): Diseases and Surgery of the Canine Conjunctiva and Nictitating Membrane. pp. 945-975. In: Gellat, K. N., Gilger B. C., Kern, T. J. (EDS.), Vet Ophthalmol. Wiley-Blackwell.<br \/>\n10.\tHISEY, E. A., A. GALOR and B. C. LEONARD (2023): A comparative review of evaporative dry eye disease and meibomian gland dysfunction in dogs and humans. Vet. Ophthalmol. 26, 16-30. 10.1111\/vop.13066.<br \/>\n11.\tKARI, O., T. HAAHTELA, P. LAINE, J. P. TURUNEN, M. KARI, S. SARNA, T. LAITINEN and P. T. KOVANEN (2010): Cellular characteristics of non-allergic eosinophilic conjunctivitis. Acta Ophthalmol. 88, 245-250. 10.1111\/J.1755-3768.2009.01599.X.<br \/>\n12.\tLEONARDI, A., L. MOTTERLE, M. BORTOLOTTI (2008): Allergy and the eye. Clin. Exp. Immunol. 153, 17-21. 10.1111\/J.1365-2249.2008.03716.X.<br \/>\n13.\tLEONARDI, A., F. PILIEGO, A. CASTEGNARO, D. LAZZARINI, A. LA GLORIA VALERIO, P. MATTANA and I. FREGONA (2015): Allergic conjunctivitis: A cross-sectional study. Clinical and Experimental Allergy 45, 1118-1125. 10.1111\/cea.12536.<br \/>\n14.\tLOUREN\u00c7O-MARTINS, A. M., E. DELGADO, I. NETO, M. C. PELETEIRO, M. MORAIS-ALMEIDA and J. H. D. CORREIA (2011): Allergic conjunctivitis and conjunctival provocation tests in atopic dogs. Vet. Ophthalmol. 14, 248-256. 10.1111\/j.1463-5224.2011.00874.x.<br \/>\n15.\tOFRI, R., N. J. MILLICHAMP, C. KELLER, G. J. MCLELLAN, A. M. KOM\u00c1ROMY, D. MORTON, M. MATAS, T. M. MICHAU, S. COALL, J. SANSOM and B. C. LEONARD (2024): Concerns About a Dog Model of Dry Eye Disease. Transl. Vis. Sci. Technol. 13, 28. 10.1167\/tvst.13.3.28.<br \/>\n16.\tOLIVRY, T., D. J. DEBOER, C. FAVROT, H. A. JACKSON, R. S. MUELLER, T. NUTTALL, P. PR\u00c9LAUD (2015 (16. August)): Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet. Res. 11. 10.1186\/s12917-015-0514-6.<br \/>\n17.\tTRUMEL, C., J.-Y. DOUET and F. GRANAT (2020): Ocular Cytology of the Dog. Veterinary Cytology 188-204. 10.1002\/9781119380559.CH19.<br \/>\n18.\tVARANDAS, C., C. CARTAXEIRO, A. M. LOUREN\u00c7O, E. DELGADO and S. GIL (2020): Selected cytokine expression in dogs with alergic conjunctivitis: Correlation with disease activity. Res. Vet. Sci. 130, 33-40. 10.1016\/j.rvsc.2020.02.009.<br \/>\n<\/em><\/p>\n<\/div>\n<p><a name=\"Sazetak\"><\/a><a class=\"alignright\" href=\"#\" onclick=\"scrollToTop();return false\"> &#9650;<\/a><\/p>\n<blockquote>\n<h2>Citolo\u0161ke karakteristike o\u010dne spojnice u pasa oboljelih od atopijskog dermatitisa<\/h2>\n<hr \/>\n<div class=\"info\"><strong>Tajna KOVA\u010c<\/strong>, dr. med. vet., studentica poslijedplomskog studija veterinarskih znanosti, dr. sc. <strong>Nik\u0161a LEMO<\/strong>, dr. med. vet., redoviti profesor, <strong>Nejra PUVA\u010cA<\/strong>, dr. med. vet., dr. sc. <strong>Lidija MEDVEN ZAGRADI\u0160NIK<\/strong>, dr. med. vet., docentica, Veterinarski fakultet Sveu\u010dili\u0161ta u Zagrebu, Zagreb, Hrvatska<\/div>\n<hr \/>\n<p>Atopijski dermatitis je kroni\u010dna, pruriti\u010dna upalna bolest ko\u017ee koja poga\u0111a oko 10 % pasa diljem svijeta. Bolest \u010desto zapo\u010dinje u ranoj dobi, uzrokuju\u0107i svrbe\u017e i sekundarne ko\u017ene lezije na specifi\u010dnim anatomskim podru\u010djima. Patofiziologija pse\u0107eg atopijskog dermatitisa (<em>canine atopic dermatitis<\/em> \u2013 CAD) nije u potpunosti razja\u0161njena, no nova istra\u017eivanja pokazuju slo\u017eeniju interakciju izme\u0111u poreme\u0107aja ko\u017ene barijere, alergijske senzibilizacije i mikrobne disbioze. Unato\u010d dobro poznatoj povezanosti atopijskog dermatitisa i konjunktivitisa, prevalencija konjunktivitisa u pasa s CAD-om \u010desto je podcijenjena u klini\u010dkoj praksi zbog neadekvatnog prepoznavanja simptoma i nedostatka specifi\u010dnih dijagnosti\u010dkih protokola.<br \/>\nOvo istra\u017eivanje imalo je za cilj analizirati citolo\u0161ke karakteristike o\u010dne spojnice u pasa oboljelih od atopijskog dermatitisa. Uzorci su prikupljeni od 24 psa s dijagnosticiranim CAD-om koji su lije\u010deni u Sveu\u010dili\u0161noj veterinarskoj bolnici Veterinarskog fakulteta Sveu\u010dili\u0161ta u Zagrebu. Citolo\u0161ka analiza provedena je na uzorcima dobivenim citolo\u0161kom \u010detkicom. Rezultati su pokazali prisutnost upalnih stanica u svim uzorcima, pri \u010demu su limfociti bili najzastupljeniji (87,5 %). Zabilje\u017een je blagi stupanj metaplazije spojnice kod svih pasa, neovisno o tipu upalnih stanica i stupnju konjunktivtisa. Ovi nalazi ukazuju na to da atopijski dermatitis mo\u017ee prouzro\u010diti promjene u o\u010dnim spojnicama koje nisu nu\u017eno povezane s intenzitetom upalnog odgovora.<br \/>\nPrisutnost limfocita, zajedno s eozinofilima u nekim slu\u010dajevima, potvr\u0111uje dijagnosti\u010dku vrijednost citolo\u0161ke analize o\u010dne spojnice u pasa s CAD-om.<br \/>\nNadalje, pove\u0107ana gusto\u0107a vr\u010dastih stanica ukazuje na sli\u010dnosti u patofiziologiji o\u010dnih alergija u ljudi i pasa, \u0161to otvara mogu\u0107nosti za daljnja istra\u017eivanja u cilju boljeg razumijevanja i lije\u010denja ovih stanja.<br \/>\nOva studija nagla\u0161ava va\u017enost interdisciplinarnog pristupa u dijagnostici i terapiji atopijskog dermatitisa, uklju\u010duju\u0107i redovite oftalmolo\u0161ke preglede kao dio standardne klini\u010dke prakse.<\/p>\n<p><strong>Klju\u010dne rije\u010di:<\/strong> <em>atopijski dermatitis, alergijski konjunktivitis, citolo\u0161ka analiza, psi<\/em><\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"<p>T. Kova\u010d*, N. Lemo, N. Puva\u010da and L. Medven Zagradi\u0161nik Tajna KOVA\u010c*, DVM, PhD student at Doctoral Studies In Veterinary<\/p>\n","protected":false},"author":8,"featured_media":0,"menu_order":7,"comment_status":"closed","ping_status":"open","template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[2443,2442,2444,1973],"issuem_issue":[2423],"ppma_author":[704],"class_list":["post-8099","article","type-article","status-publish","format-standard","hentry","category-original-scientific-articles","tag-allergic-conjunctivitis","tag-atopic-dermatitis","tag-cytological-analysis","tag-dogs","issuem_issue-veterinarska-stanica-56-3"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Cytological Characteristics of the Eye Conjunctiva in Dogs with Atopic Dermatitis - CROATIAN VETERINARY JOURNAL<\/title>\n<meta name=\"description\" content=\"This study highlights the importance of an interdisciplinary approach in the diagnosis and treatment of atopic dermatitis, including regular ophthalmologic examinations as part of standard clinical practice.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/journal.h3s.org\/?article=cytological-characteristics-of-the-eye-conjunctiva-in-dogs-with-atopic-dermatitis\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cytological Characteristics of the Eye Conjunctiva in Dogs with Atopic Dermatitis - 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