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Hoerdemann M, Yarbrough T. Long-term outcome of autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia. Vet Surg 2023; 52:1032-1040. [PMID: 37309748 DOI: 10.1111/vsu.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To describe the technique, postoperative complications, and outcome after autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia. STUDY DESIGN Retrospective case series. ANIMALS Eleven horses with ulcerative keratitis and keratomalacia. METHODS Horses included had undergone fascia lata grafting with conjunctival flap overlay due to impending or recent corneal perforation. Preceding therapy, lesion characteristics, postoperative complications, and short- and long-term outcomes were recorded. RESULTS Postoperative complications included complete (1/11) or partial (2/11) dehiscence of the conjunctival flap and fascia lata graft, postoperative pneumonia (1/11), intermittent hypercreatinemia (2/11) and mild uveitis after trimming of the conjunctival flap (9/10). The donor sites healed without complications (11/11). A satisfactory short-term outcome (at cessation of medical therapy) was achieved in all horses (11/11). Long-term follow-up (median 29 months, range 7-127 months) was available for 10/11 horses. A comfortable eye with functional vision was achieved in 9/10 horses with long-term follow-up, including 3/4 horses with prior corneal perforation and 1/11 horses in which the fascia lata graft completely dehisced 15 days after surgery. Enucleation was required in a single horse (1/10) after phthisis bulbi developed 7 months postoperatively. CONCLUSION Fascia lata grafting with conjunctival flap overlay appears to be a viable solution for globe preservation in horses with ulcerative keratitis and keratomalacia. Long-term ocular comfort with functional visual outcomes can be achieved in most cases with limited concerns for donor site morbidity while bypassing acquisition, storage or lesion-size limitations related to other biomaterials.
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Mo PM, Picard J, Gummow B. The conjunctival fungal microflora of horses in a North Queensland tropical environment and their in vitro susceptibilities to antifungal agents. Vet Res Commun 2023; 47:1641-1651. [PMID: 37022654 PMCID: PMC10485094 DOI: 10.1007/s11259-023-10119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023]
Abstract
Fungi are ubiquitous in the environment and part of the commensal microflora on the conjunctiva of equine eyes. North Queensland, being tropical, presents an ideal environment for fungi growth. When the cornea is injured, fungi can invade the corneal stroma, resulting in keratomycosis. The objectives of this study were to determine the fungal species specific to the eyes of horses in the Townsville region; to investigate the potential risk factors associated with the presence of fungi; and to test their susceptibility to antifungals to create an empirical guide for treatment. The eyes of forty ophthalmologically normal horses from James Cook University were sampled throughout the summer months of December 2017, January 2018, and January and February 2020. Cultured fungi were identified morphologically, and their identity confirmed by comparing partial 18sRNA DNA sequences with the NCBI nucleotide database. Minimum inhibitory concentration testing of common antifungal medications was performed. Sixty-one out of eighty conjunctival samples grew fungi, and 21 different fungi genera were isolated. The most common genera were Aspergillus (18%, 26/141), Curvularia (14%,20/141), Rhodotorula (12%,17/141) and Penicillium (12%,17/141). No significant association was found between age or environmental factors and fungal culture status. Most fungi were highly susceptible to voriconazole and ketoconazole but resistant to fluconazole and amphotericin B. This adds to the body of evidence on which species of fungi are present as normal ocular microflora of horses living in tropical regions of Australia, and an avenue for treating them.
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Affiliation(s)
- Phu Mo Mo
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia.
| | - Jacqueline Picard
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - Bruce Gummow
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
- Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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Dawson C. A problem‐based approach to the ‘red eye’. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. Dawson
- Royal Veterinary College Hatfield Hertfordshire UK
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Martabano BB, Linde Henriksen M, Powell CC. Prevalence of equine ulcerative keratomycosis in Colorado and association of environmental factors: A retrospective and descriptive study (2002–2017). EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. B. Martabano
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - M. Linde Henriksen
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - C. C. Powell
- Department of Clinical Sciences Comparative Ophthalmology College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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Mustikka MP, Grönthal TSC, Pietilä EM. Equine infectious keratitis in Finland: Associated microbial isolates and susceptibility profiles. Vet Ophthalmol 2019; 23:148-159. [PMID: 31364808 PMCID: PMC7004187 DOI: 10.1111/vop.12701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/05/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland. ANIMALS AND PROCEDURES Medical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed. RESULTS Forty-seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes. Aspergillus flavus was the most frequent fungal isolate (9/17, 53%), followed by Cylindrocarpon sp. (3/17, 18%) and Aspergillus fumigatus (2/17, 12%). Susceptibility was tested for 10/11 Aspergillus sp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B. Cylindrocarpon sp. isolates were resistant to both agents. Streptococcus equi subsp. zooepidemicus was the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13 Streptococcus sp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty-six of the eyes underwent globe-sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively. CONCLUSIONS Although Aspergillus sp. and S zooepidemicus were the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.
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Affiliation(s)
- Minna P Mustikka
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Thomas S C Grönthal
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Elina M Pietilä
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
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Berkowski WM, Craft WF, Whitley RD, Brooks DE, Plummer CE. Equine ulcerative keratitis with furrow: A review of the outcomes of 72 cases from 1987 to 2015. Equine Vet J 2019; 51:749-755. [PMID: 30883892 DOI: 10.1111/evj.13101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 03/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ulcerative keratitis with peripheral furrow formation is a poorly-described condition which has been associated with a grave prognosis due to rapid necrosis of the cornea. OBJECTIVE To describe the infectious aetiologies associated with furrow-forming ulcerative keratitis, its overall clinical course and the efficacy of medical and surgical intervention in horses. STUDY DESIGN Retrospective clinical case series. METHODS Medical records of 72 horses which presented with furrow-forming ulcerative keratitis at the University of Florida between 1987 and 2015 were reviewed. RESULTS Seventy-two horses (72 eyes) with furrow-forming ulcerative keratitis were treated at the University of Florida between 1987 and 2015. Of these, a definitive aetiologic diagnosis was available for 37 eyes. Ten of 37 eyes (27%) were diagnosed with fungal keratitis based on cytology of corneal scraping, culture, histopathology and/or fungal PCR. Fourteen of 37 eyes (38%) were diagnosed with a mixed fungal and bacterial keratitis. Thirteen of 37 eyes (35%) were diagnosed with bacterial keratitis. Overall, 26 of 72 total eyes were treated with medical therapy alone (36%). Forty-six of 72 eyes were treated medically and surgically (64%). Of the 26 eyes which received medical therapy, 20 healed with a positive visual outcome (77%) and 6 eyes were non-visual (23%). Of the 46 eyes which received surgical intervention, 40 healed with a positive visual outcome (87%), while six eyes were non-visual (13%). Altogether, 60 of 72 eyes healed with a positive visual outcome following medical or surgical treatment of furrow-forming ulcerative keratitis (83%). Twelve of 72 eyes failed treatment (17%), with six eyes requiring enucleation and six globes becoming phthisical after treatment. MAIN LIMITATIONS Inconsistencies in available medical record data due to the large span of time (1987-2015) are inherent in this retrospective study, along with gradual evolution of corneal surgical techniques and medical therapies over the decades. CONCLUSIONS Furrow-forming ulcerative keratitis was associated with a positive visual outcome in 83% of horses treated at the University of Florida between the years 1987 and 2015. Furrow formation may be associated with either fungal or bacterial infection.
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Affiliation(s)
- W M Berkowski
- Comparative Ophthalmology, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - W F Craft
- Department of Anatomic Pathology, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - R D Whitley
- Comparative Ophthalmology, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - D E Brooks
- Comparative Ophthalmology, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - C E Plummer
- Comparative Ophthalmology, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Effect of bone marrow-derived mesenchymal stem cells and stem cell supernatant on equine corneal wound healing in vitro. Stem Cell Res Ther 2017; 8:120. [PMID: 28545510 PMCID: PMC5445363 DOI: 10.1186/s13287-017-0577-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 12/14/2022] Open
Abstract
Background We aimed to determine and compare the in vitro effects of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) and mesenchymal stem cell supernatant (MSC-Sp) on the wound healing capacity of equine corneal fibroblasts using a scratch assay. Methods Bone marrow aspirates and eyes were collected from normal, euthanized horses with subsequent isolation and culture of BM-MSCs and corneal stromal cells. Corneal stromal cells were culture-expanded in the culture well of transwell plates and then treated with an autologous BM-MSC suspension (dose: 2.5 × 105/100 μL media with the BM-MSCs contained within the insert well), MSC-Sp solution, or naive culture media (control) for 72 h. A linear defect in confluent cell cultures was created (i.e., corneal scratch assay) to assess the cellular closure (“healing”) over time. Three representative areas of the scratch in each culture were photographed at each time point and the scratch area was quantitated using image analysis software (ImageJ). Media from the scratches were analyzed for various growth factors using human enzyme-linked immunosorbent assay (ELISA) kits that crossreact with the horse. Results There was a significant percentage decrease in the scratch area remaining in the BM-MSC and MSC-Sp groups compared to the control group. There was also a significant percentage decrease in the scratch area remaining in the BM-MSC group compared to the MSC-Sp group at 36 h post-scratch and all time points thereafter. The concentration of transforming growth factor (TGF)-β1 in the media was significantly higher in the BM-MSC group compared to the control group. Conclusions The significant decrease in scratch area in equine corneal fibroblast cultures treated with autologous BM-MSCs compared to MSC-Sp or control treatments suggests that BM-MSCs may substantially improve corneal wound healing in horses. MSC-Sp may also improve corneal wound healing given the significant decrease in scratch area compared to control treatments, and would be an immediately available and cost-effective treatment option. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0577-3) contains supplementary material, which is available to authorized users.
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Simeone CA, Traversi JP, Meegan JM, LeBert C, Colitz CMH, Jensen ED. Clinical management of Candida albicans keratomycosis in a bottlenose dolphin (Tursiops truncatus). Vet Ophthalmol 2017; 21:298-304. [PMID: 28074638 DOI: 10.1111/vop.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Corneal ulceration secondary to trauma commonly affects marine mammals, often with opportunistic secondary bacterial or fungal infections. This report characterizes the combined use of auriculopalpebral and ophthalmic nerve blocks, adipose-derived stem cells, and subconjunctival injections for successful treatment of corneal trauma and infection in dolphins. ANIMAL STUDIED An 11-year-old, female bottlenose dolphin (Tursiops truncatus) presented with bilateral diffuse corneal opacities, which progressed to keratomycosis caused by Candida albicans. PROCEDURE Aggressive medical management was employed, including the use of subconjunctival injections of adipose-derived stem cells, plasma, topical and oral antifungals and antibiotics, and anti-inflammatory and pain medications. Anesthetic block of the auriculopalpebral and ophthalmic nerves was employed to evaluate the corneas. CONCLUSION Subconjunctival injections were employed over 52 days, followed by topical drops for 5 months. At last evaluation, there was no evidence of blepharospasm bilaterally. Only a faint superficial gray corneal opacity remained OS. A temporal paraxial corneal opacity was present OD, with receding inactive vascularization and a small amount of melanosis temporally.
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Affiliation(s)
| | | | - Jenny M Meegan
- National Marine Mammal Foundation, San Diego, CA, 92106, USA
| | - Carolina LeBert
- National Marine Mammal Foundation, San Diego, CA, 92106, USA
| | | | - Eric D Jensen
- U.S. Navy Marine Mammal Program, Space and Naval Warfare Systems Center Pacific, San Diego, CA, 92152, USA
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Delph KM, Sharpe E, Beard LA, Rankin AJ. Haemolytic anaemia and bilateral uveitis associated with leptospirosis in a 6‐year‐old Quarter Horse gelding. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- K. M. Delph
- Department of Clinical Sciences Kansas State University Manhattan Kansas USA
| | - E. Sharpe
- Department of Clinical Sciences Kansas State University Manhattan Kansas USA
| | - L. A. Beard
- Department of Clinical Sciences Kansas State University Manhattan Kansas USA
| | - A. J. Rankin
- Department of Ophthalmology Kansas State University Manhattan Kansas USA
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Sherman AB, Clode AB, Gilger BC. Impact of fungal species cultured on outcome in horses with fungal keratitis. Vet Ophthalmol 2016; 20:140-146. [PMID: 27061354 DOI: 10.1111/vop.12381] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the significance of Aspergillus and Fusarium spp., as identified by culture, on clinical outcome in equine keratomycosis. METHODS Retrospective analysis of 66 horses (66 eyes) evaluated at the NCSU-VH diagnosed with keratomycosis from which Aspergillus or Fusarium spp. were cultured. Horses were classified into those who improved with medical management alone or those who required surgical intervention to improve. Horses who underwent surgery were divided into globe-sparing procedures or enucleation. Effects of bacterial co-infection, previous topical steroid or antifungal use, and time of year on fungal genus and outcome were evaluated. RESULTS Aspergillus spp. was cultured from 41 eyes (63%), while 24 eyes (37%) cultured Fusarium spp. One horse cultured both species and was not included in further evaluation. From the horses that cultured Aspergillus spp., 28 eyes (68%) required surgical intervention to control the infection: 21 (75%) of these eyes maintained globe integrity, while 7 eyes (25%) were enucleated. Of those horses with Fusarium spp., 14 eyes (58%) required surgical intervention: 11 (79%) of these eyes maintained globe integrity, while 3 eyes (21%) were enucleated. Genus of fungus cultured was not significantly associated with the need for surgical intervention nor was it significantly associated with the necessity of globe-sparing surgery versus enucleation. Additionally, bacterial co-infection, previous steroidal or antifungal use, and time of year did not affect outcome or type of fungal species cultured. CONCLUSION Equine keratomycosis from Fusarium spp. compared to keratomycosis from Aspergillus spp. is not associated with a different clinical outcome.
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Affiliation(s)
- Amanda B Sherman
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
| | - Alison B Clode
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
| | - Brian C Gilger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr, Raleigh, NC, 27607, USA
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Mancuso LA, Lassaline M, Scherrer NM. Porcine urinary bladder extracellular matrix grafts (ACell Vet®Corneal Discs) for keratomalacia in 17 equids (2012-2013). Vet Ophthalmol 2014; 19:3-10. [DOI: 10.1111/vop.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Laura A. Mancuso
- New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; 382 W. Street Road Kennett Square PA 19348 USA
| | - Mary Lassaline
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California-Davis; One Shields Avenue Davis CA 95616 USA
| | - Nicole M. Scherrer
- New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; 382 W. Street Road Kennett Square PA 19348 USA
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Clinical features and outcomes of severe ulcerative keratitis with medical and surgical management in 41 horses (2000-2006). EQUINE VET EDUC 2010. [DOI: 10.2746/095777309x400270] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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