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Preston JF, Mustikka MP, Priestnall SL, Dunkel B, Fischer MC. Clinical features and outcomes of horses presenting with presumed equine immune mediated keratitis to two veterinary hospitals in the United Kingdom and Finland: 94 cases (2009-2021). Equine Vet J 2024. [PMID: 39183684 DOI: 10.1111/evj.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/30/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND There is limited literature regarding equine immune mediated keratitis (IMMK) in Europe. North America-based publications describe minimal blepharospasm, rare corneal ulceration and no uveitis; clinical impression suggests these are seen in Europe. OBJECTIVES Assess the prevalence of blepharospasm, corneal ulceration and uveitis and their impact on outcome in horses diagnosed with IMMK in Europe (UK and Finland). STUDY DESIGN Retrospective case series. METHODS Clinical records of 94 horses with IMMK were evaluated. The UK and Finland populations were comparable; therefore, descriptive statistics were performed on combined data on subtypes of IMMK and clinical features. Odds ratios (OR) and confidence intervals (CI) were calculated for impact of blepharospasm, ulceration or presence of uveitis on the outcome of enucleation and treatment duration. RESULTS IMMK subtype was classified as 10/94 (10.6%) epithelial, 50/94 (53.2%) anterior stromal, 14/94 (14.9%) mid-stromal, 4/94 (4.25%) endothelial and 16/94 (17.0%) unrecorded. After excluding three horses with incidental corneal ulceration, blepharospasm was documented in 34/91 (37.4%), corneal ulceration in 26/91 (28.6%), and signs of uveitis in 23/91 (25.3%) horses. Increased odds of enucleation were significantly associated with the presence of blepharospasm (OR 5.5, 95% CI 1.6-19.4, p = 0.008) and signs of uveitis (OR 8.9, 95% CI 2.6-30.8, p < 0.001), but not corneal ulceration. The presence of blepharospasm, corneal ulceration or uveitis did not significantly alter the odds of ongoing medication. MAIN LIMITATIONS Data were collected over a wide timeframe; the diagnosis was mainly made without histopathology; a broad definition of uveitis was used and there was a bias towards complicated cases being retained for follow-up. CONCLUSIONS The clinical features of IMMK were similar between two European countries but differed to USA descriptions. Blepharospasm, corneal ulceration and signs of uveitis can occur with IMMK; presence of blepharospasm and uveitis increase the odds of enucleation.
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Affiliation(s)
- Juliette F Preston
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Minna P Mustikka
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Simon L Priestnall
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Bettina Dunkel
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Maria-Christine Fischer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Cattaneo A, Guandalini A, Peruccio C. Preliminary observations on tear film interferometry performed in horses. J Equine Vet Sci 2024; 133:105002. [PMID: 38218326 DOI: 10.1016/j.jevs.2024.105002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
This retrospective study evaluated tear film (TF) interferometry on horses examined in Northern Italy in 2019-2021. The objectives were to evaluate horses affected by keratitis, and to describe TF values in horses with no evidence of ocular disease. All horses received a complete ophthalmic examination and were examined with the Ocular Surface Analyser, Veterinary-setting, prior to eye manipulation, staining and sample collection. Eighteen horses with no evidence of ocular disease were included in the comparison group. Additionally, 46 horses displaying signs of keratitis (neovascularization, corneal opacities, ulceration, epithelial and subepithelial infiltrates) were evaluated. These horses were divided into presumed non-infectious and infectious or presumed infectious keratitis groups (one with proven bacterial origin, and the others with diagnosed or presumptive keratomycosis) with the former including immune-mediated keratitis. From the observations of TF interferometry in the comparison population the authors concluded that for non-invasive break-up time (NIBUT), the estimated preliminary reference interval was 10.4-31.2s, and for tear meniscus height (TMH), it was 0.215-0.457mm. Moreover, within the keratitis population, from an interferometric point of view punctate lesions of the ocular surface were present in all cases of active diagnosed or presumptive subepithelial keratomycosis but not in any of the non-infectious cases, either non-ulcerative or ulcerative. Limitations of the study include a relatively low number of horses examined and the fact that the diagnosis of infectious keratitis was presumptive and based on clinical improvement after treatment in some cases. To the authors' knowledge, this is the first report of TF interferometry performed in horses.
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Affiliation(s)
- A Cattaneo
- Equine Ophthalmic Referrals, Via Endine 29, Albino (Bg) 24021, Italy; Ophthalmology Referrals, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, Roma (Rm) 00137, Italy.
| | - A Guandalini
- Ophthalmology Referrals, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, Roma (Rm) 00137, Italy
| | - C Peruccio
- Ophthalmology Referrals, Centro Veterinario Torinese (CVT), Lungo Dora Pietro Colletta 147, Torino (To) 10153, Italy
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Padjasek M, Cisło-Sankowska A, Lis-Bartos A, Qasem B, Marycz K. PLDLA/TPU Matrix Enriched with Cyclosporine A as a Therapeutic Platform for Immune-Mediated Keratitis (IMMK) in Horses. Int J Mol Sci 2023; 24:ijms24065735. [PMID: 36982806 PMCID: PMC10057311 DOI: 10.3390/ijms24065735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/05/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
The purpose of this study was to describe the use of PLDLA/TPU matrix enriched with cyclosporine A (CsA) as a therapeutic platform in horses with immune-mediated keratitis (IMMK) with an in vitro evaluation CsA release and degradation of the blend as well as determination of the safety and efficacy of that platform used in the animal model. The kinetics of the CsA release from matrices constructed of thermoplastic polyurethane (TPU) polymer and a copolymer of L-lactide with DL-lactide (PLDLA) (80:20) in the TPU (10%) and a PLDL (90%) polymer blend were studied. Moreover, we used the STF (Simulated Tear Fluid) at 37 °C as a biological environment to assess the CsA release and its degradation. Additionally, the platform described above was injected subconjunctival in the dorsolateral quadrant of the globe after standing sedation of horses with diagnosed superficial and mid-stromal IMMK. The obtained results indicated that the CsA release rate in the fifth week of the study increased significantly by the value of 0.3% compared to previous weeks. In all of the cases, the TPU/PLA doped with 12 mg of the CsA platform effectively reduced the clinical symptoms of keratitis, leading to the complete remission of the corneal opacity and infiltration four weeks post-injection. The results from this study showed that the PLDLA/TPU matrix enriched with the CsA platform was well tolerated by the equine model and effective in treating superficial and mid-stromal IMMK.
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Affiliation(s)
- Martyna Padjasek
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Anna Cisło-Sankowska
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Anna Lis-Bartos
- Department of Biomaterials and Composites, Faculty of Material Science and Ceramics, AGH University of Science and Technology, Aleja Adama Mickiewicza 30, 30-059 Krakow, Poland
| | - Badr Qasem
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Krzysztof Marycz
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
- Correspondence:
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Abstract
This article provides a brief, clinically relevant review of neurologic disorders of the eye. A description of the neuro-ophthalmic examination is provided. Stepwise descriptions of the most common neuro-ophthalmic abnormalities are provided along with common rule outs.
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Scherrer NM, Lassaline M, Miller WW. Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap. Vet Ophthalmol 2016; 20:65-72. [DOI: 10.1111/vop.12342] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nicole M. Scherrer
- New Bolton Center; University of Pennsylvania School of Veterinary Medicine; 382 West Street Rd Kennett Square PA 19348 USA
| | - Mary Lassaline
- Department of Radiological and Surgical Sciences; University of California; 1 Shields Ave Davis CA 95616 USA
| | - William W. Miller
- Memphis Veterinary Specialists; 555 Trinity Creek Cove Cordova TN 38018 USA
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Vallone LV, Neaderland MH, Ledbetter EC, Dubielzig RR. Suspected malignant transformation of B lymphocytes in the equine cornea from immune-mediated keratitis. Vet Ophthalmol 2015; 19:172-9. [DOI: 10.1111/vop.12275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lucien V. Vallone
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | | | - Eric C. Ledbetter
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - Richard R. Dubielzig
- Department of Pathological Sciences; College of Veterinary Medicine; University of Wisconsin; Madison WI 53706 USA
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Pinto NI, McMullen RJ, Linder KE, Cullen JM, Gilger BC. Clinical, histopathological and immunohistochemical characterization of a novel equine ocular disorder: heterochromic iridocyclitis with secondary keratitis in adult horses. Vet Ophthalmol 2014; 18:443-56. [DOI: 10.1111/vop.12234] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Nelson I. Pinto
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27606 USA
| | - Richard J. McMullen
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27606 USA
- Pferdeklinik Munich-Riem; Munich 81929 Germany
| | - Keith E. Linder
- Department of Population Health and Pathobiology; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27606 USA
| | - John M. Cullen
- Department of Population Health and Pathobiology; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27606 USA
| | - Brian C. Gilger
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh NC 27606 USA
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Rushton JO, Tichy A, Kolodziejek J, Nowotny N, Nell B. Prevalence of linear keratopathy in a herd of Lipizzaners over an 18-month period. Vet Rec 2013; 173:192. [PMID: 23839726 DOI: 10.1136/vr.101710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The prevalence of linear keratopathy with progressing age in a closed population of a single horse breed is reported. All Lipizzaners in three federal states in Austria underwent complete ophthalmic examination four times over a period of 18 months, with six-month intervals. Findings consistent with linear keratopathy were recorded, and associated with factors such as sex, location, boarding system and level of performance throughout the study period. Logistic regression was applied to determine the influence of age on ophthalmic findings. On the first, second, third and fourth examinations, 0.8 per cent, 3.1 per cent, 4.4 per cent and 4.8 per cent (of 266, 261, 249 and 230 horses, respectively) of the study population, were diagnosed with linear keratopathy. This finding was consistently identified in the same horses, and once identified, no further progression was noted. Horses with this finding had no history of previous ocular problems or concurrent ocular abnormalities. Statistical analysis did not reveal any influence of sex, location, boarding, or level of performance; however the prevalence of linear keratopathy was found to increase with progressive age (P<0.5). The results of this study indicate that linear keratopathy was not congenital and was non-progressive in the Lipizzaner over a period of 18 months.
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Affiliation(s)
- J O Rushton
- Department of Companion Animals and Horses, University of Veterinary Medicine, Veterinaerplatz 1, Vienna, Austria.
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Gilger BC, Stoppini R, Wilkie DA, Clode AB, Pinto NH, Hempstead J, Gerding J, Salmon JH. Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices. Vet Ophthalmol 2013; 17 Suppl 1:23-30. [DOI: 10.1111/vop.12087] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Brian C. Gilger
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | | | - David A. Wilkie
- Department of Veterinary Clinical Sciences; The Ohio State University; 601 Vernon Tharp Street Columbus OH 43210 USA
| | - Alison B. Clode
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | - Nelson H. Pinto
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | - Julie Hempstead
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | - Joseph Gerding
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | - Jacklyn H. Salmon
- Department of Clinical Sciences; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
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Rushton J, Tichy A, Brem G, Druml T, Nell B. Ophthalmological findings in a closed herd of Lipizzaners. Equine Vet J 2012; 45:209-13. [PMID: 23009263 DOI: 10.1111/j.2042-3306.2012.00630.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING THE STUDY There are no studies on the ophthalmic health status in the Lipizzaner breed. OBJECTIVE To perform an ophthalmological survey in a closed herd in 3 housing systems. MATERIALS All horses at the Federal Stud Piber, Heldenberg and the Spanish Riding School Vienna were subjected to ophthalmological examination. Findings were documented and correlated with factors such as age, gender, location and housing situation. The interrelation of abnormalities of different regions was determined by calculating accuracy. Pedigree analysis of horses affected by cataract was performed. RESULTS A total of 267 horses met the inclusion criteria of this study. Of these, 172 horses were stabled in Piber, 72 in Vienna and 23 in Heldenberg. Ophthalmological examination revealed 203 cases with ocular findings, predominantly involving the conjunctiva (44.6%), cornea (21.7%) and fundus (37.5%). In 24 (8.9%) horses a diagnosis of cataract was made. There was no interrelation between different eye diseases. Horses stabled at Piber were significantly more affected by conjunctival and fundic abnormalities. Fewer abnormalities were found in horses stabled in open boxes. Access to free stalls resulted in more cases of conjunctivitis. Pedigree analysis showed no evidence of inbreeding as a cause of cataract formation. CONCLUSION AND POTENTIAL RELEVANCE Acquired corneal abnormalities were over-represented in this study. This survey may serve as a basis for further research on the pathogenesis of ophthalmic diseases in Lipizzaners.
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Affiliation(s)
- J Rushton
- Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.
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11
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Greenberg SM, Plummer CE, Brooks DE, Porter M, Farina LL, Winter MD. Unilateral orbital lacrimal gland abscess in a horse. Vet Ophthalmol 2011; 14:55-60. [DOI: 10.1111/j.1463-5224.2010.00842.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Immune mediated keratopathies (IMMKs) are a relatively commonly occurring group of heterogeneous corneal disorders. This paper describes the currently recognised clinical presentations of the IMMKs in the USA and in the UK. Although a clinical diagnosis is relatively straightforward in most cases, the specific aetiopathogeneses of the IMMKs remains elusive and largely speculative, but are thought to be based upon upregulated immunoreactivity in the normally immunologically passive cornea. Treatment protocols, both medical and surgical, are based primarily on collective clinical experience and are variably successful, and in some cases recurrence or refractoriness to treatment is possible.
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Affiliation(s)
- A Matthews
- McKenzie Bryson and Marshall, Kilmarnock, Scotland, UK
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Matthews AG. An overview of recent developments in corneal immunobiology: potential relevance in the etiogenesis of corneal disease in the horse. Vet Ophthalmol 2008; 11 Suppl 1:66-76. [DOI: 10.1111/j.1463-5224.2008.00635.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
OBJECTIVE The purpose of this study is to describe clinical and histologic findings, treatment, and outcome of horses with suspected immune-mediated keratitis (IMMK). DESIGN Retrospective study. ANIMALS Nineteen horses that presented to NCSU-VTH from 1998 to 2004 with IMMK. Procedures Information retrieved from the medical records included signalment, duration of clinical signs, therapy prior to initial examination, ophthalmic abnormalities, diagnostics performed, therapy instituted, and long-term vision. RESULTS Nineteen horses (22 eyes) were diagnosed with IMMK. Three distinct clinical groups were identified based on the depth of the lesion in the cornea: superficial stromal (n = 11 eyes), midstromal (n = 6 eyes), or endothelial (n = 5 eyes). Horses ranged from 5 to 19 years of age, with a mean age +/- SD of 11.9 +/- 3.6 years. Eleven horses had 12 months or greater duration of clinical signs of corneal disease prior to referral. Overall there was a mean duration of 11.8 +/- SD 8.3 months. Superficial stromal keratitis appeared as a superficial stromal cellular infiltrate with diffuse vascularization. Midstromal keratitis appeared as midstromal cellular infiltrate with mild, surrounding corneal edema and vascularization. Endothelial disease appeared as endothelial cellular infiltrate with diffuse corneal edema. In all types of IMMK, signs of uveitis or severe discomfort were not observed. CONCLUSIONS AND CLINICAL RELEVANCE Horses with superficial IMMK responded to topical medical therapy, but responded best to surgical removal of the lesion. Horses with midstromal keratitis responded to topical cyclosporine therapy. Endothelial disease was the least amenable to therapy.
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Affiliation(s)
- Brian C Gilger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
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Ollivier FJ. The precorneal tear film in horses: its importance and disorders. Vet Clin North Am Equine Pract 2004; 20:301-18. [PMID: 15271425 DOI: 10.1016/j.cveq.2004.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The precorneal tear film (PTF) is of critical importance in the physiologic and pathologic findings of the cornea. Clinicians should recall that quantitative and qualitative disorders of the PTF can be a cause of corneal diseases as well as a clinical sign of ocular surface diseases. It is also important to consider that some systemic and topical treatments may affect the PTF volume and composition. Not all interactions are known at this time. There is a continued need for basic research into PTF components in healthy and diseased equine eyes, because much remains unknown. Until additional basic information about the biochemical composition and pH of the PTF as well as the interactions between equine corneal pathogens and specific PTF deficits becomes available, it will not be possible to define the cause and effect relations precisely between the various ocular surface diseases and deficiencies,excesses, and imbalances of PTF components. It is quite possible that a number of equine corneal diseases may be manifestations of qualitative PTF disorders.
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Affiliation(s)
- Franck J Ollivier
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, PO Box 100126, Gainesville, FL 32610, USA.
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