Role of Leptospira spp. testing and ocular examination in horses with equine recurrent uveitis: A retrospective study of 63 horses

Uveitis and blindness in a closed herd of Equidae following leptospiral infection

Objective

To describe the ocular findings, chronology of disease, and serum leptospiral titers in a group of horses, mules, and donkeys following an outbreak of leptospirosis.

Methods

Fifty Equidae in central North Carolina had ophthalmic examinations and serum leptospiral microscopic agglutination test (MAT) titers performed every 3-6 months for 24 months followed by a final examination at 34 months.

Results

Throughout the nearly three-year study period, 17 horses (34%; 17/49 horses) developed signs of uveitis; 20 eyes (20/34; 58.8%) of these 17 horses were visual at the initial examination, but only four eyes (11.8%) remained visual at the final examination. Serum titers (serogroups Pomona and Bratislava) in horses with uveitis were significantly elevated compared to Equidae without uveitis (p < 0.02). In the 32 horses, donkeys, and mules that did not develop uveitis, a subgroup of 11 horses and one donkey had negative or low serum leptospiral titers (titers ≤1:800) while a second subgroup of 16 horses, three mules, and one donkey had high leptospiral titers (>1:800) but never developed uveitis. Water sources in the pasture were found to have high levels of leptospira.

Conclusion

Approximately 1/3 of horses on a farm exposed to Leptospira developed uveitis and blindness. Serum titers to L. Pomona and L. Bratislava were significantly elevated in horses with uveitis. However, despite exposure, some horses, even with very high serum titers, never developed ocular disease. These data indicates that further research is warranted to investigate the genetic and immunological aspects of the pathogenesis and susceptibility of leptospiral-associated uveitis.

Seroprevalence of Equine Leptospirosis in the State of Goiás, Brazil

Leptospirosis, caused by Leptospira, is a zoonotic disease that, in horses, is linked to abortions, uveitis, and sporadic occurrences of liver and kidney disease, often resulting in significant economic losses for farmers. Research on the prevalence of leptospirosis in horses in the central-west region of Brazil has been relatively scarce. Thus, the present study aimed to determine the prevalence of leptospirosis in equine herds in the state of Goiás (Central Brazil). Blood samples were collected from 894 equids at 294 randomly selected farms divided into three different strata according to their herd characteristics. The microscopic agglutination test for the detection of anti-Leptospira agglutinins was carried out and the results showed that among the 294 sampled farms, 213 (72.9%; CI 95% 71.7-78.9) had one or more animals positive for leptospirosis, and of the 894 horses sampled, 513 (61.6%; CI 95% 54.3-69.0) were seropositive for leptospirosis. Djasiman, Icterohaemorrhagiae, and Australis were the most prevalent serogroups. The results showed a high prevalence of seropositive animals and a widespread distribution of positive farms in the state of Goiás. Thus, environmental sanitation measures and health education to prevent and control equine leptospirosis in the state are required.

Infectious Uveitis in Horses and New Insights in Its Leptospiral Biofilm-Related Pathogenesis

Uveitis is a sight-threatening eye disease in equids known worldwide that leads to considerable pain and suffering. By far the most common type of uveitis in Germany and neighboring countries is classical equine recurrent uveitis (ERU), which is caused by chronic intraocular leptospiral infection and is the main cause of infectious uveitis in horses. Other infectious causes are extremely rare and are usually clinically distinguishable from ERU. ERU can be treated very effectively by vitreous cavity lavage (vitrectomy). For proper indications of this demanding surgery, it is necessary to differentiate ERU from other types of uveitis in which vitrectomy is not helpful. This can be conducted on the basis of anamnesis in combination with ophthalmologic findings and by aqueous humor examination. During vitrectomy, vitreous material is obtained. These vitreous samples have historically been used for numerous etiologic studies. In this way, a chronic intraocular leptospiral infection has been shown to be the cause of typical ERU and, among other findings, ERU has also been recognized as a biofilm infection, providing new insights into the pathogenesis of ERU and explaining some thus far unexplainable phenomena of ERU. ERU may not only have transmissible aspects to some types of uveitis in humans but may also serve as a model for a spontaneously occurring biofilm infection. Vitreous material obtained during therapeutically indicated vitrectomy can be used for further studies on in vivo biofilm formation, biofilm composition and possible therapeutic approaches.

Detection of Anti-LipL32 Antibodies in Serum Samples from Horses with Chronic Intraocular Infection with Leptospira spp

Equine recurrent uveitis (ERU) is typically caused by chronic intraocular leptospiral infection in warm-blooded horses in central Europe. The most effective therapy for leptospiral-induced ERU is the surgical removal of diseased vitreous (vitrectomy). Since vitrectomy is a highly specialized and invasive surgery, the indication must be determined very carefully. In order to obtain evidence of intraocular leptospiral infection by laboratory diagnostics in questionable leptospiral ERU-cases, sampling of aqueous humor is required, because serum tests using microscopic agglutination test (MAT) are too unspecific. The SNAP Lepto is a cross-species rapid test for the detection of anti-Lipl32 antibodies that has a high sensitivity (0.97) and specificity (1.00) for the detection of anti-leptospiral antibodies using aqueous humor or vitreous samples, which is comparable to MAT. To evaluate sensitivity and specificity of SNAP Lepto using serum, serum samples from 90 horses with confirmed leptospiral ERU and from 103 ocularly healthy horses were tested by both MAT and SNAP Lepto. Sensitivity was similar for both tests (0.82 vs. 0.79), but specificity was lower for MAT (0.52 vs. 0.95). Sensitivity and specificity are therefore lower in serum samples compared to intraocular samples, however, the SNAP Lepto is far superior to MAT and suitable as a screening method using equine serum.