Dr. Strom is a Board-Certified Veterinary Ophthalmologist. She received her veterinary degree from the University of Copenhagen, completed her Master’s thesis on canine glaucoma at the University of Zurich, Switzerland. She then completed her residency training in comparative ophthalmology at the University of California, Davis and then stayed for 2 years as a clinical instructor. She is a reviewer for the Veterinary Ophthalmology journal and The Journal of Feline Medicine and Surgery and Journal of Feline Medicine and Surgery Open Report. She maintains a strong interest in microsurgery, ocular toxicology, advanced diagnostic imaging, optics, and comparative ophthalmology and vision research.
Subcutaneous administration of triamcinolone as part of the management of feline eosinophilic keratoconjunctivitis.
J Feline Med Surg. 2020 Nov 03;:1098612X20968660
Authors: Lucyshyn DR, Good KL, Knickelbein KE, Chang MW, Strøm AR, Hollingsworth SR, Thomasy SM, Leonard BC, Sebbag L, Wiggans KT, Maggs DJ
OBJECTIVES: The aim of this retrospective case-control study was to report the efficacy of subcutaneous triamcinolone as part of a regimen for feline eosinophilic keratoconjunctivitis (FEK).
METHODS: Records and clinical photographs were reviewed and lesions semi-quantitatively graded for cats with cytologically confirmed FEK. Clinical data were compared between a study population of nine cats (11 eyes) treated with, and a reference population of seven cats (eight eyes) treated without, a median 0.11 mg/kg (range 0.10-0.20 mg/kg) of triamcinolone acetonide subcutaneously.
RESULTS: Breed, sex, age and prevalence of corneal ulceration at presentation; corneal disease severity before and at the initiation of immunomodulation; and duration of antiviral treatment before immunomodulation did not differ significantly between populations (P ⩾0.059). Corneal plaques resolved in five cats each from the study and reference populations (P = 0.366). Median (range) time from immunomodulation to corneal plaque resolution did not significantly differ (P = 0.246) between the study (median 14 days; range 8-38 days) and reference (median 28 days, range 14-46 days) populations. No adverse reactions were attributed to triamcinolone administration, and all corneal ulcers in the study population re-epithelialized within 14 days (range 8-38 days) following triamcinolone injection. Time to corneal ulcer re-epithelialization following triamcinolone injection varied minimally in those receiving antivirals prior to (8 or 30 days until re-epithelialization), simultaneously with (38 days) or after (14 or 24 days) triamcinolone.
CONCLUSIONS AND RELEVANCE: In otherwise healthy cats with FEK, subcutaneous administration of triamcinolone appears to be well tolerated and as efficacious as conventional topical immunomodulatory therapies. It may be especially useful in ulcerated eyes where topical immunomodulation is contraindicated.
PMID: 33140999 [PubMed - as supplied by publisher]
Equine eosinophilic keratoconjunctivitis in California: retrospective study of 47 eyes from 29 cases (1993-2017).
Vet Ophthalmol. 2019 Jan 31;:
Authors: Knickelbein KE, Luethy D, Thomasy SM, Reilly C, Strom AR, Lassaline ME
OBJECTIVE: (a) To evaluate the epidemiology of equine eosinophilic keratoconjunctivitis (EK) in the western United States, (b) to ascertain the efficacy of keratectomy and diamond burr debridement vs medical management alone, (c) to determine the efficacy of various medical therapies, and (d) to further characterize the histopathologic findings of the disease in horses.
ANIMALS STUDIED: Twenty-nine horses (47 eyes) diagnosed with EK from 1993 to 2017.
PROCEDURE: Retrospective medical record review; owner questionnaire.
RESULTS: Average age of presentation was 11 ± 4 years. Warmbloods were significantly overrepresented (P = 0.024). Twenty horses were treated with medical therapy alone, five were treated with superficial lamellar keratectomy, and four were treated with diamond burr debridement. Follow-up data were available for 38 eyes of 23 horses. Median time to resolution for horses treated with either superficial keratectomy or diamond burr debridement (62 days) was not statistically significantly different from those that underwent medical therapy alone (46 days; P = 0.33). Eyes treated with topical steroids had a statistically significant longer median time to resolution (61 days) compared to those that did not receive topical steroid (44 days; P = 0.023). Common histopathologic findings in keratectomy samples included the presence of eosinophils, vascularization, and an eosinophilic membrane spanning areas of ulceration.
CONCLUSION: In this population, time to EK resolution was similar for horses treated with medical and surgical management. The use of topical steroids was associated with a prolonged time to resolution. Keratectomy samples from horses with EK had similar findings to those reported in other species.
PMID: 30706617 [PubMed - as supplied by publisher]
A multidisciplinary, minimally invasive approach combining lacrimoscopy and fluoroscopically guided stenting for management of nasolacrimal apparatus obstruction in dogs.
J Am Vet Med Assoc. 2018 Jun 15;252(12):1527-1537
Authors: Strom AR, Culp WTN, Leonard BC, Dear JD, Wisner ER, Johnson LR, Maggs DJ
OBJECTIVE To describe and evaluate outcomes of a multidisciplinary, minimally invasive approach combining lacrimoscopy and fluoroscopically guided stenting for management of nasolacrimal apparatus (NLA) obstruction in dogs. DESIGN Prospective, nonrandomized clinical trial. ANIMALS 16 client-owned dogs with confirmed NLA obstruction. PROCEDURES Dogs underwent CT contrast dacryocystorhinography, rhinoscopy, and lacrimoscopy. Whenever possible, the NLA was stented, typically with fluoroscopic guidance. RESULTS Median duration of clinical signs prior to treatment was 3.2 months (range, 0.2 to 14 months). Causes of NLA obstruction were a foreign body (n = 5), dacryocystitis (4), stenosis secondary to fibrosis (3), granulation tissue (1), or granulation tissue in association with a small foreign body (1); a cause was not identified in 2 dogs. Stents were placed in 14 of 16 (88%) dogs for a median duration of 5.6 weeks (range, 1.3 to 9.4 weeks). Stenting was not possible in 2 dogs with stenosis of the NLA secondary to granulation tissue or fibrosis. Owners of all 16 dogs reported at least 60% clinical improvement with median improvement rated as 95%, and owners of 8 dogs reporting complete resolution of signs. Two dogs required antimicrobial administration because of dacryocystitis that persisted after stent removal; a foreign body was not found in either dog. CONCLUSIONS AND CLINICAL RELEVANCE Overall clinical response and owner-rated improvement for dogs with NLA obstruction that underwent lacrimoscopy and fluoroscopically guided stenting were high, especially given that these dogs had failed to respond to conventional treatment.
PMID: 29889638 [PubMed - in process]
Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs.
Vet Ophthalmol. 2018 May 15;:
Authors: Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, Hollingsworth SR, Strom AR, Good KL, Thomasy SM, Kass PH, Wisner ER
OBJECTIVE: To compare the effectiveness of retrobulbar anesthesia (RBA) and peribulbar anesthesia (PBA) in dogs.
ANIMAL STUDIED: Six adult mixed-breed dogs (18-24 kg).
PROCEDURES: In a randomized, masked, crossover trial with a 10-day washout period, each dog was sedated with intravenously administered dexmedetomidine and administered 0.5% bupivacaine:iopamidol (4:1) as RBA (2 mL via a ventrolateral site) or PBA (5 mL divided equally between ventrolateral and dorsomedial sites). The contralateral eye acted as control. Injectate distribution was evaluated by computed tomography. Following intramuscularly administered atipamezole, corneal and periocular skin sensation, intraocular pressure (IOP), and ocular reflexes, and appearance were evaluated for 24 hours. Comparisons were performed with mixed-effects linear regression (IOP) or the exact Wilcoxon signed rank test (scores). Significance was set at P ≤ .05.
RESULTS: Injectate distribution was intraconal in 2/6 RBA- and 4/6 PBA-injected eyes. Eyes undergoing PBA had significantly reduced lateral, ventral, and dorsal periocular skin sensation for 2-3 hours, and significantly reduced corneal sensitivity for 4 hours, relative to control eyes. Chemosis and exophthalmos occurred in 33%-40% of eyes undergoing RBA and 83%-100% eyes undergoing PBA but resolved within 14 hours. Anterior uveitis developed in 2/6 and 1/6 eyes of RBA and PBA, respectively, of them corneal ulcer developed in one eye of each treatment. Both resolved 1-3 days following medical treatment.
CONCLUSIONS: Peribulbar injection produced notable anesthesia more reliably than did retrobulbar injection. Both techniques may produce adverse effects, although the uveitis/ulcer could have resulted from the contrast agent used.
PMID: 29762893 [PubMed - as supplied by publisher]
Utility of antigen testing for the diagnosis of ocular histoplasmosis in four cats: a case series and literature review.
J Feline Med Surg. 2017 Oct;19(10):1110-1118
Authors: Smith KM, Strom AR, Gilmour MA, LaDouceur E, Reilly CM, Byrne BA, Affolter VK, Sykes JE, Maggs DJ
Case series summary This case series describes the clinical utility of antigen testing for the diagnosis of feline ocular histoplasmosis. Four cats with suspected (n = 2) or confirmed (n = 2) ocular histoplasmosis are described: three from Oklahoma and one from California. In one case, serial urine antigen tests, as well as a serum antigen test for Histoplasma capsulatum, were negative; however, light microscopy identified microorganisms consistent with H capsulatum in ocular tissues at necropsy. In a further two cats with recurrent ocular histoplasmosis following long-term systemic antifungal therapy, Histoplasma species urine antigen concentrations were negative, but both cats improved clinically following systemic antifungal therapy and remained in apparent clinical remission after treatment cessation (9-16 months). The final cat displayed profound bilateral endophthalmitis; however, Histoplasma species antigen testing of vitreous humor and subretinal fluid from the left eye was negative. Intralesional organisms were detected on histopathology of both eyes, and H capsulatum was subsequently isolated and sequenced from tissue of one eye. Relevance and novel information These cases highlight the potential difficulty in definitively diagnosing ocular histoplasmosis in cats when conducting antigen testing of serum, urine and even ocular fluids. Although antigen testing has previously proven useful in the diagnosis of disseminated feline histoplasmosis, it may not be adequate in cats with only ocular signs.
PMID: 27527560 [PubMed - in process]
Oral administration of famciclovir for treatment of spontaneous ocular, respiratory, or dermatologic disease attributed to feline herpesvirus type 1: 59 cases (2006-2013).
J Am Vet Med Assoc. 2016 Sep 01;249(5):526-38
Authors: Thomasy SM, Shull O, Outerbridge CA, Lim CC, Freeman KS, Strom AR, Kass PH, Maggs DJ
OBJECTIVE To evaluate outcomes for cats treated with orally administered famciclovir 3 times/d for clinical signs attributed to naturally occurring feline herpesvirus type 1 (FHV-1) infection and to assess variables related to owner satisfaction with the treatment. DESIGN Retrospective case series. ANIMALS 59 client-owned cats. PROCEDURES Medical records were reviewed to identify cats treated for presumed FHV-1 infection from 2006 through 2013 with ≥ 1 follow-up visit. Signalment, duration of clinical signs, prior treatment, examination findings, diagnostic test results, concurrent treatments, and outcome data were recorded. Owners were asked to complete a survey regarding patient- and treatment-related variables. Data were compared between cats that received low (approx 40 mg/kg [18 mg/lb]) and high (approx 90 mg/kg [41 mg/lb]) doses of famciclovir, PO, 3 times/d. RESULTS Patient age ranged from 0.03 to 16 years. Conjunctivitis (51/59 [86%]), keratitis (51 [86%]), blepharitis (19 [32%]), nasal discharge or sneezing (10 [17%]), and dermatitis (4 [7%]) were common findings. Clinical improvement was subjectively graded as marked in 30 (51%) cats, mild in 20 (34%), and nonapparent in 9 (15%). Median time to improvement was significantly shorter, and degree of improvement was significantly greater in the highdose group than in the low-dose group. Adverse effects potentially attributable to famciclovir administration were reported for 10 cats. On the basis of survey responses, most (29/32 [91%]) owners were satisfied with their cat's treatment. CONCLUSIONS AND CLINICAL RELEVANCE Famciclovir at the prescribed dosages was associated with improved clinical signs in cats with presumed FHV-1 infection, and few adverse effects were attributed to the treatment. Further studies are needed to assess whether a famciclovir dosage of 90 versus 40 mg/kg, PO, 3 times/d would result in increased efficacy and shorter treatment time.
PMID: 27556267 [PubMed - indexed for MEDLINE]
Epidemiology of canine glaucoma presented to University of Zurich from 1995 to 2009. Part 2: secondary glaucoma (217 cases).
Vet Ophthalmol. 2011 Mar;14(2):127-32
Authors: Strom AR, Hässig M, Iburg TM, Spiess BM
OBJECTIVE: To investigate the epidemiology of canine secondary glaucomas in the cases presented to the University of Zurich, Vetsuisse Faculty (UZH) from 1995 to 2009 focusing on possible risk factors for developing secondary glaucoma in this population of dogs.
METHODS: Information was obtained from the computer database of patients examined by members of the UZH Ophthalmology Service, between January 1995 and August 2009. Secondary glaucoma was diagnosed based on the presence of antecedent eye conditions. The data was evaluated for breed, gender, age at presentation, and for antecedent eye conditions known to cause glaucoma including anterior uveitis of unknown cause (AU), lens luxation (LL), intraocular surgery (SX), intraocular neoplasia (IN), unspecified trauma to the globe (T), ocular melanosis (OM), hypermature cataract (PY), hyphema (HY), and six other less frequent conditions.
RESULTS: A total of 217 dogs were diagnosed with secondary glaucoma from 1995 to 2009. The age of the dogs with secondary glaucoma ranged between 88 days and 19 years (mean 7.7 ± 3.6 years). Data suggested a predisposition for secondary glaucoma in the Cairn Terrier and the Jack Russell Terrier breeds from 2004 to 2009. Common causes of secondary glaucoma from 1995 to 2009 were AU (23.0%), LL (22.6%), SX (13.4%), IN (10.6%), T (8.3%), OM and PY (both 6.9%) and HY (3.23%).
CONCLUSION: The report presents the epidemiology of secondary glaucomas presented to UZH from 1995 to 2009. Fourteen risk factors were recorded for secondary glaucoma. This is the first paper documenting OM in the Swiss Cairn Terrier dog population.
PMID: 21366829 [PubMed - indexed for MEDLINE]
Epidemiology of canine glaucoma presented to University of Zurich from 1995 to 2009. Part 1: Congenital and primary glaucoma (4 and 123 cases).
Vet Ophthalmol. 2011 Mar;14(2):121-6
Authors: Strom AR, Hässig M, Iburg TM, Spiess BM
OBJECTIVE: To investigate the epidemiology of canine congenital and primary glaucoma in the cases presented to the University of Zurich, Vetsuisse Faculty (UZH) from 1995 to 2009.
METHODS: Information was obtained from the computer database of patients examined by members of the UZH Ophthalmology Service, between January 1995 and August 2009. Congenital and primary glaucoma was diagnosed based on the age of onset, the lack of evidence of any antecedent eye conditions, and/or the presence and severity of iridocorneal angle defects. The data was evaluated for breed, gender and age at presentation.
RESULTS: A total of 5984 dogs presented to the UZH Ophthalmology service between 1995 and 2009. Four dogs of different breed were diagnosed with congenital glaucoma and 123 dogs were diagnosed with primary glaucoma. For the primary glaucomas the overall male to female ratio (M:F) was 1:1.41 and the age of onset ranged from 0.12 to 18.3 years with a mean of 7.3 ± 3.6 years. Data suggested a predisposition for primary glaucoma in the Siberian Husky, Magyar Vizsla and Newfoundland from 2004 to 2009.
CONCLUSION: The report presents the epidemiology of canine congenital and primary glaucomas presented to the UZH from 1995 to 2009. A previous suspicion of predisposition for primary glaucoma in the Newfoundland dog (n = 6) and the Magyar Vizsla breed (n = 8) was confirmed.
PMID: 21366828 [PubMed - indexed for MEDLINE]