Multimodal Advanced Imaging and Long-Term Follow-Up of Peters Anomaly Type 2, With Presumed Lenticular Material in the Cornea, in a Scottish Terrier.

OCT and IVCM can reveal detailed anterior segment pathology, including presumed intrastromal lenticular remnants, in Peters anomaly type 2.

This case report describes a bilateral presentation of Peters anomaly type 2 in an 8-week-old male Scottish Terrier, followed clinically for 3 years with advanced multimodal imaging performed at 37 weeks of age. Peters anomaly type 2 is a form of anterior segment dysgenesis characterized by central corneal leukoma with keratolenticular adhesion. The left eye demonstrated more severe pathology, including a keratolenticular adhesion extending into the mid-stroma, progressive cataract, microphthalmia, goniodysgenesis, and secondary glaucoma. The right eye showed a milder leukoma with spontaneous separation of the keratolenticular adhesion and no significant progression. Optical coherence tomography (OCT) delineated a posterior stromal defect involving Descemet's membrane and endothelium, with extension of the keratolenticular adhesion into the mid-stroma. In vivo confocal microscopy (IVCM) revealed endothelial cell loss, polymegathism, pleomorphism, stromal fibrosis, vascularization, and multiple highly refractile structures within the mid-stroma, interpreted as presumed lenticular material—a finding not previously reported in veterinary medicine. This case highlights the value of advanced imaging modalities, particularly OCT and IVCM, in characterizing anterior segment abnormalities obscured by corneal opacity. These tools provided clinically significant detail beyond what was achievable on standard ophthalmic examination and may inform prognosis and management decisions in similar cases.

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