The study of equine eyes encompasses various anatomical, physiological, and pathological aspects of the horse's visual system. The equine eye is a complex organ adapted for a wide field of vision and low-light conditions, which is essential for the survival of prey animals. Key components include the cornea, lens, retina, and optic nerve, each playing a role in capturing and processing visual information. Common ocular conditions in horses include uveitis, cataracts, and corneal ulcers, which can affect vision and overall health. Diagnostic techniques such as ophthalmoscopy and ultrasonography are employed to assess eye health and detect abnormalities. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, and diseases of the equine eye, as well as advancements in diagnostic and therapeutic approaches.
Hendrix DV, Stuffle JL, Cox SK.To evaluate the pharmacokinetics of topically applied ciprofloxacin 0.3% ophthalmic solution in tears of healthy horses. Methods: Twenty healthy, adult, mixed-breed horses. Methods: Twenty study horses were confirmed free of ophthalmic disease by complete ophthalmic examination. Seventy microliters of 0.3% ciprofloxacin (Ciloxan) was placed in the ventral cul-de-sac of each eye using a microliter syringe and 19-g cannula. Population kinetics were carried out by sampling the tear film from the lower cul-de-sac of each eye with tear test strips at 5, 10, 15 and 30 min and 1, 2, 4 and 6 h post ad...
Sandmeyer LS, Breaux CB, Archer S, Grahn BH.To determine the prevalence of congenital stationary night blindness (CSNB) in Appaloosa horses in western Canada, investigate the association with the leopard complex of white spotting patterns, and further characterize the clinical and electroretinographic aspects of CSNB in the Appaloosa. Methods: Three groups of 10 Appaloosas were studied based on coat patterns suggestive of LpLp, Lplp, and lplp genotype. Methods: Neurophthalmic examination, slit-lamp biomicroscopy, indirect ophthalmoscopy, measurement of corneal diameter, streak retinoscopy, scotopic and photopic full-field and flicker ER...
Hayes S, Boote C, Lewis J, Sheppard J, Abahussin M, Quantock AJ, Purslow C, Votruba M, Meek KM.This study is a comparative study of the relationship between corneal structure, morphology, and function in a range of mammalian species. X-ray scattering patterns were gathered at regular spatial intervals over the excised cornea (and in most cases also the scleral rim) of humans, marmosets, horses, cows, pigs, rabbits, and mice. All patterns were analyzed to produce quantitative information regarding the predominant orientation of fibrillar collagen throughout the tissue. The predominant direction of corneal collagen varies between mammals. This variation is not related to the size, shape, ...
Gasthuys F, Pockelé K, Vervaet C, Weyenberg W, De Prijck K, Pille F, Vlaminck L, Nelis H, Remon JP.The in vivo behaviour of 5% gentamicin sulphate ocular mini-tablets (2-mm diameter, 6.525 mg weight) was compared with gentamicin eye drops in six ponies. Two mini-tablets were inserted on the bulbar conjunctiva of the right eye while a similar dose of gentamicin was administered via eye drops in the left eye. Irritation induced by the mini-tablets and the eye drops was evaluated using a visual analogue scale (0-10). Tears were sampled with ophthalmologic absorption triangles for 1 min for the determination of the concentration of gentamicin sulphate using a microbiological plate diffusion met...
Matiasek K, Cronau M, Schmahl W, Gerhards H.A 25-year-old Haflinger gelding was evaluated for chronic-progressive unilateral exophthalmos. Ultrasonographic investigation and magnetic resonance (MR) imaging revealed a retrobulbar space-occupying mass to be the cause of eyeball displacement. Ultrasonographic features were not sufficient to specify the type and extension of the lesion. Magnetic resonance scans, however, clearly displayed an infiltrative intracranial growth pattern but sparing of orbital soft tissues. Based on MR appearance, tentative diagnosis of an orbital soft tissue neoplasia was made and subsequently confirmed by histo...
Nardoni S, Sgorbini M, Barsotti G, Corazza M, Mancianti F.To identify and quantify ocular fungi from healthy donkeys living in the center of Italy. Methods: One hundred and two Amiata donkeys were examined. Methods: Conjunctival swabs from both eyes were seeded onto Sabouraud dextrose agar (SDA) and malt extract agar (MEA), and incubated at 25 degrees C over a 10-day period. Filamentous fungi identification was achieved to the genus level; yeast colonies were identified for macro-micromorphologic and physiological characteristics. Results: Eighty-one donkeys out of 102 (79.4%) were positive for fungi; 47/102 (46.1%) had positive cultures from both ey...
Schaer BD.The emergency clinician is frequently in the position of receiving, evaluating, and initiating treatment on horses with ophthalmic emergencies or orbital trauma. In the best of circumstances, an ophthalmologist is available to guide initial therapy and ultimately assume responsibility for the management of the patient during the remainder of its hospitalization, but this is not always the case. The information presented here is meant to provide the emergency clinician with basic guidelines for the initial assessment and management of horses sustaining ocular injuries or presented with an ophth...
Evans KE, McGreevy PD.It has recently been reported that a strong correlation exists between the distribution of retinal ganglion cells and nose length in the domestic dog. To determine if this phenomenon occurs in another domestic species with diverse skull morphology, the current study examined the distribution of retinal ganglion cells in 30 horses from a variety of breeds. There was a significant variation in the density of ganglion cells found across the retinae. Breed was a significant predictor for ganglion cell density within the visual streak. A strong positive correlation exists between the density of gan...
Morreale RJ, Wilkie DA, Gemensky-Metzler AJ, Weisbrode SE, Willis MA.To determine the acute histologic effects of semiconductor diode laser transscleral cyclophotocoagulation (TSCP) on the normal equine eye. Methods: Part 1: eight eyes of four horses. Part 2: 10 eyes of five horses. Methods: Part 1: TSCP was performed on four eyes at 4 mm and four eyes at 6 mm posterior to the limbus with 15 sites treated in four quadrants at 1800 mW for 1500 ms. The globes were sectioned transversely or sagitally to examine all quadrants and histologic sections were taken every 1 mm for the entire globe. Part 2: Based on the results from Part 1, TSCP was performed at 20 sites ...
Bourges-Abella N, Raymond-Letron I, Diquelou A, Guillot E, Regnier A, Trumel C.To describe the cells observed in conjunctival brush cytology (CBC) from normal horses and compare these findings with conjunctival structural histology so as to understand which cells are recovered from CBC. Methods: This study was divided into three parts. (1) Conjunctival brush smears were collected from 20 healthy horses on both eyes and a differential count on 300 cells was carried out on May Grünwald-Giemsa (MGG) smears. (2) A similar protocol was used for whole eyes from five horses obtained rapidly after death from a slaughterhouse. The eyes were then assessed for conjunctival histolo...
Plummer CE, Smith S, Andrew SE, Lassaline ME, Gelatt KN, Brooks DE, Kallberg ME, Ollivier FJ.The purpose of this study was to evaluate the effectiveness of postoperative beta-irradiation with strontium-90 as an adjunctive treatment to superficial keratectomy and permanent bulbar conjunctival graft for removal of equine corneolimbal squamous cell carcinoma (SCC), in decreasing recurrence rate. Methods: The retrospective case study included 38 horses diagnosed and treated for SCC of the eye that involved the limbus and/or cornea. The patients were treated between 1990 and 2002, with strontium-90 irradiation immediately after corneal and conjunctival graft surgery. Recurrence was defined...
Niedermaier G, Wollanke B, Hoffmann R, Brem S, Gerhards H.Equine recurrent uveitis (ERU) is caused by persistent intraocular leptospira, which appear to use the vitreous body as a refuge. The detection of leptospira in the vitreous body of horses with spontaneous ERU by histological methods has not yet been described. Thirty eight vitreous body samples from 36 horses with ERU (collected during vitrectomy), and 10 vitreous body samples obtained from 5 horses without ocular disease (control group) were examined by transmission electron microscopy. Prior to sample collection, 2 ml of a leptospira culture suspension were injected into the vitreous body o...
Barsotti G, Sgorbini M, Nardoni S, Corazza M, Mancianti F.The fungal flora of the normal conjunctival fornix has been described for many animal species (Urban et al., 1972; Samuelson et al., 1984; Moore et al., 1988; Davidson et al., 1994; Cooper et at, 2001) and many environmental factors, such as age, geography, habitat and husbandry are reported to influence its composition (Samuelson at at, 1984; Andrew et at, 2003). Equine keratomycosis can be caused by saprophytic fungi following an underlying corneal pathology or improper use of topical antibiotics and/or topical corticosteroids (Andrew at al., 1998; Brooks, 1999). Knowledge of differences in ...
Betbeze CM, Wu CC, Krohne SG, Stiles J.To evaluate the in vitro antifungal properties of silver sulfadiazine (SSD) and natamycin against filamentous fungi isolated from eyes of horses with keratomycosis. Methods: Filamentous fungal isolates obtained from eyes of keratomycosis-affected horses. Methods: Fungal culture of ocular samples yielded 6 Fusarium spp; 7 Aspergillus spp; and 1 isolate each of Curvularia, Scopulariopsis, Penicillium, and Chrysosporium. For each fungal isolate, minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of SSD and natamycin were determined. Results: For all 17 fungal isolat...
Byam-Cook KL, Henson FM, Slater JD.Treatment of the equine sarcoid has posed a significant challenge to clinicians for years and many different methods have been tried with varying success, including ionising radiation. The aim of this study was to review the efficacy of iridium-192 interstitial brachytherapy for the treatment of eight periocular sarcoids and 15 non-ocular sarcoids on 18 horses. All the periocular sarcoids and 13 of the 15 non-ocular sarcoids were treated successfully.
McMullen RJ, Gilger BC.To determine ocular dimensions (A- and B-scan ultrasound) and corneal curvature (radius of corneal diameter determined in B-scan ultrasound) in the equine eye and to calculate the appropriate dioptric power for a posterior chamber intraocular lens (IOL) necessary to achieve emmetropia in the eyes of horses undergoing lens extraction. Methods: Fourteen clinically normal adult horses of various breeds. Additionally, for comparison, one American Miniature colt foal, and one 2.5-year-old Shire gelding were examined. Methods: B-scan ultrasound was performed on one eye from each horse. One eye from ...
Borchers K, Ebert M, Fetsch A, Hammond T, Sterner-Kock A.Equine herpes virus 2 (EHV-2), a gamma(2)-herpesvirus, is common in horses of all ages. Its role as a primary pathogen is unclear but there is an association between EHV-2, respiratory disease and keratoconjunctivitis. The purpose of this study was to gain more information on the prevalence of EHV-2 DNA in conjunctival swabs from horses with and without ocular disease and to define the anatomical site and cell type harbouring viral genome or antigen. By polymerase chain reaction (PCR) 22 out of 77 (28.6%) ocular swabs of clinically healthy and only 4 out of 48 (8.3%) samples from diseased hors...
Niedermaier G, Wollanke B, Hoffmann R, Matiasek K, Gerhards H.Neither the ultrastructure of the vitreous body from horses without ocular diseases, nor the pathomorphological changes in the vitreous body associated with equine recurrent uveitis (ERU) have been described. However, the vitreous body plays an important role in the pathogenesis of ERU. Ten vitreous body samples obtained from 5 horses without ocular disease, and 38 vitreous body samples from horses with ERU (collected during vitrectomy) were examined by transmission electron microscopy. The vitreous body samples of horses without ocular diseases were characterized by a loose network of unbranc...
Serena A, Joiner KS, Schumacher J.Hemangiopericytoma (HP) is a well-recognized neoplasm arising from vascular pericytes that has been reported only in the dog and man. In this study, we describe a 14-year-old female Arabian horse that was presented for surgical excision of a 2-cm-diameter expansile subcuticular mass in the right lower eyelid. Histologically, the mass consisted of loosely arranged interlacing streams and storiform bundles of spindle cells that often formed distinct whorls around a central capillary and bundles of collagen (Antoni A-like pattern). Immunohistochemical analysis revealed strong diffuse cytoplasmic ...
Komáromy AM, Garg CD, Ying GS, Liu C.To evaluate the effect of head position on intraocular pressure (IOP) in horses. Methods: 30 horses. Methods: Horses were sedated with detomidine HCl (0.01 mg/kg, IV). Auriculopalpebral nerve blocks were applied bilaterally with 2% lidocaine HCl. The corneas of both eyes were anesthetized with ophthalmic 0.5% proparacaine solution. Intraocular pressures were measured with an applanation tonometer with the head positioned below and above heart level. The mean of 3 readings was taken for each eye at each position for data analysis. The effect of head position on IOP was assessed and generalized ...
Rampazzo A, Eule C, Speier S, Grest P, Spiess B.The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. Results: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% present...
Rayner SG, Van Zyl N.To assess the effectiveness of topical mitomycin C application as an alternative adjunctive therapy to CO2 laser ablation in the treatment of equine ocular squamous cell carcinoma. Methods: A retrospective clinical study of eight client owned horses in which 10 affected eyes were treated for ocular squamous cell carcinoma over a 17 month period. (March 2003 to August 2004). Methods: Each horse was given a general anaesthetic to allow CO2 laser ablation of the lesion(s). Mitomycin C at a concentration of 0.4 mg/mL was then applied intraoperatively to the affected areas for 1 or 5 minutes. Posto...
Hurn SD, Turner AG.To record the prevalence and document the types of eye disease in population of Thoroughbred racehorses in Victoria, Australia. Methods: Prospective study. Methods: Two hundred four Thoroughbred racehorses. Methods: All horses and both eyes were examined at four metropolitan and two country racing stable complexes. Ophthalmic exam was performed following dark adaptation with a transilluminator, biomicroscope, and direct ophthalmoscope. Intraocular pressures were measured when indicated. Both pupils were dilated with tropicamide when indicated. Results: One hundred eighty-two (89.2%) flat-racin...
Scheck JL.A stallion was presented for surgical treatment of limbal squamous cell carcinoma. Excision with a conjunctival pedicle flap was done to prevent ocular invasion and preserve vision. A complication was the diagnosis of atrial fibrillation, which was not converted to sinus rhythm due to the potential complication of treatment with quinidine sulfate. Traitement d’un carcinome épidermoïde oculaire chez un étalon atteint de fibrillation auriculaire. Un étalon a été présenté pour une chirurgie d’un carcinome épidermoïde limbique. Après l’excision, un lambeau à pédicule conjonctiva...
Brünott A, van der Velden MA.In this case report a 20-year-old horse with unilateral eosinophilic keratitis is presented. The occurrence, clinical symptoms, histological findings and treatment of this ocular disorder are described and discussed against the background of relevant literature. Local administration of 0.1% dexamethason was successful.
Verma A, Artiushin S, Matsunaga J, Haake DA, Timoney JF.Recurrent uveitis as a sequela to Leptospira infection is the most common infectious cause of blindness and impaired vision of horses worldwide. Leptospiral proteins expressed during prolonged survival in the eyes of horses with lesions of chronic uveitis were identified by screening a phage library of Leptospira interrogans DNA fragments with eye fluids from uveitic horses. Inserts of reactive phages encoded several known leptospiral proteins and two novel putative lipoproteins, LruA and LruB. LruA was intrinsically labeled during incubation of L. interrogans in medium containing [14C]palmiti...
Lassaline ME, Brooks DE, Ollivier FJ, Komaromy AM, Kallberg ME, Gelatt KN.Amniotic membrane has antifibrotic, anti-angiogenic and antiprotease properties. This retrospective study was designed to investigate the use of equine amniotic membrane transplants (AMT) at preserving vision, maintaining the structural integrity of the globe and maximizing cosmesis in equine eyes with corneal ulceration and severe keratomalacia. Methods: Equine amnion had previously been aseptically harvested from a 12-year-old Thoroughbred mare during an elective Cesarean section. Sections of amnion were stored at -80 degrees C and thawed as needed. Records of equine cases at the University ...
Gilmour MA, Clarke CR, Macallister CG, Dedeo JM, Caudell DL, Morton RJ, Pugh M.To investigate intraocular penetration of orally administered doxycycline in the normal equine eye and to compare intraocular and serum doxycycline concentrations. Procedures Six mares were administered doxycycline at 10 mg/kg every 12 h by nasogastric tube for 5 days. Blood, aqueous, and vitreous samples were collected on days 1 and 5. All samples were assayed for doxycycline concentrations. Aqueous and vitreous samples were also assayed for protein quantitation. Results: Doxycycline was rapidly absorbed after the first dose (T(max) value of 1.42 +/- 1.28 h); and elimination of doxycycline oc...
Mathes RL, Paige Carmichael K, Peroni J, Anthony Moore P.A 5-year-old Draft Horse gelding presented for evaluation of a large, fleshy, ulcerated third eyelid mass OD of 3 weeks duration. Complete ophthalmic examination, ocular ultrasound and skull radiographs revealed a large soft-tissue mass involving the entire third eyelid OD and extending into the ventral right orbit to the level of the globe equator. No other abnormalities were noted on physical or ophthalmic examination. Surgical removal via exenteration was performed 3 months after initial presentation. A lacrimal adenocarcinoma of the third eyelid was diagnosed based on histopathology. Concu...
Uhl PB, Amann B, Hauck SM, Deeg CA.Retinal pigment epithelium (RPE) builds the outer blood-retinal barrier of the eye. Since one typical feature of the autoimmune disease, equine recurrent uveitis (ERU), is the breakdown of this barrier, we recently performed comparative analysis of healthy and uveitic RPE. We identified for the first time peripherin 2, which is responsible for visual perception and retina development, to be localized in RPE. The purpose of this study was therefore to validate our findings by characterizing the expression patterns of peripherin 2 in RPE and retina. We also investigated whether peripherin 2 expr...
Julien ME, Shih JB, Correa Lopes B, Vallone LV, Suchodolski JS, Pilla R, Scott EM.Next generation sequencing (NGS) studies in healthy equine eyes have shown a more diverse ocular surface microbiota compared to culture-based techniques. This study aimed to compare the bacterial ocular surface microbiota in both eyes of horses with unilateral ulcerative keratitis (UK) with controls free of ocular disease. Conjunctival swabs were obtained from both ulcerated eyes and unaffected eyes of 15 client-owned horses with unilateral UK following informed consent, as well as from one eye of 15 healthy horses. Genomic DNA was extracted from the swabs and sequenced on an Illumina platform...
Morén S, Kallberg M, Strom L.Uveitis is common in horses, potentially turning chronic (persistent or recurrent) resulting in impaired vision or blindness. All mainstay therapeutics aims at controlling inflammation, but long-term or lifelong treatment is often needed with possibly severe side effects. Therefore, intravitreal injections with low-dose gentamicin (IVGI) have been used in attempt to give a long-lasting result with potentially less side effects. Objective: To retrospectively assess outcome and long-term complications following one or two low-dose IVGI in Swedish horses with chronic uveitis. Methods: Retrospecti...
Casado-Santos A, González-Cubero E, González-Fernández ML, González-Rodríguez Y, García-Rodríguez MB, Villar-Suárez V.Corneal ulcers are a common and potentially vision-threatening condition in horses that can be challenging to treat with conventional therapies alone. This case report describes the successful treatment of a non-healing corneal ulcer in a 28-year-old Hispano-Bretón mare using the secretome derived from adipose tissue-derived mesenchymal stem cells (ASCs). Despite initial treatment with antibiotics, anti-inflammatory drugs, and surgical debridement, the corneal ulcer failed to heal properly, exhibiting persistent epithelial defects and stromal complications. As an alternative regenerative appr...
Wolframm I, Reuter P, Zaharia I, Vernooij J.This study investigated the visual search behavior of equestrian dressage judges at different expertise levels during the assessment of Grand Prix horse-rider combinations. Twenty judges (11 foundational level, 9 advanced level) participated in the study, with their eye movements recorded using Tobii Fusion Eyetracker as they evaluated video recordings of dressage tests. Fixation metrics, namely Total Duration of Fixation (TDF), Average Duration of Fixation (ADF), and Total Number of Fixations (TNF), were analyzed across four Areas of Interest (AOIs): front, back, rider, and horse's feet. Stat...
McMullen RJ.To review data on the advances in equine ophthalmic imaging that have been made during the past 5 years and highlight advantages of using multiple imaging modalities to improve clinical observational skills and improve diagnostic accuracy. Methods: A literature review from 2019 through 2024 of equine ophthalmic digital photography, fundus photography, ocular and orbital ultrasonography (US), ultrasound biomicroscopy (UBM), confocal microscopy (CM), spectral domain optical coherence tomography (SD-OCT), radiography, CT, and MRI. Results: Digital photography remains the cornerstone of equine oph...
Hill FW, Moulton JE, Schiff PH.A fifteen-year-old thoroughbred gelding with exophthalmos of the left eye, was found at necropsy to have an adenocarcinoma of the left frontal sinus. The tumour extended caudally through the cribriform plate into the orbit, displacing the eyeball anteriorly.
Rampazzo A, Eule C, Speier S, Grest P, Spiess B.The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. Results: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% present...
Gerhards H, Werry H, Deegen E, Köstlin RG.Coloboma and ectopia of the crystalline lens are rarely encountered or diagnosed congenital defects of the equine eye. The clinical and ophthalmoscopic features of a congenital coloboma of the lens in a 3 year old Hanoverian stallion and of an ectopic lens in a 6-month old Hanoverian filly are described and depicted. In the stallion, the lens coloboma was associated with a partial coloboma of the zonules, and in the filly, the ectopic lens was small and spherical (microphakia, spherophakia) and associated with syneresis of and small floaters in the vitreous. Although it cannot be excluded that...
Lavach JD, Severin GA, Roberts SM.Perforating corneal wounds in horses have a better prognosis than wounds that involve both cornea and sclera. Sharp objects tend to produce more isolated corneal wounds and have a better prognosis than do wounds produced by blunt objects. The records of 43 horses that sustained penetrating wounds of the cornea were reviewed. In addition, the surgical approach and postoperative wound management is described. The report attempts to provide more information regarding the management of ocular trauma in horses.
Matthews AG, Crispin SM, Parker J.A wide range of ophthalmoscopic variants are encountered during routine examination of the horse. Some result from minor anatomical anomalies, cause no significant effect on vision and may be considered to lie within the limits of 'biological normality'. Others are a consequence of pathological disruption of the anatomical integrity of the fundus, and may directly or indirectly affect the neurosensory retina and produce some degree of visual deficit. This paper illustrates the ophthalmoscopic appearance of a number of pathological variants of the anatomic fundus, and discusses their possible e...
Adamson PJ, Jang SS.Salmonella arizonae 61:1,5, was isolated in pure culture from the eye of a horse with unilateral ulcerative keratitis. The eye responded well to treatment with atropine sulfate and polymyxin B-bacitracin-neomycin ophthalmic ointments. In swab specimens taken after the lesion had healed, Salmonella was not found to be a constituent of the bacterial flora of the horse's eyes.
Holmberg DL.Four horses with corneal perforations of various etiologies were presented for surgical correction. Pedicle grafts taken from the bulbar or palpebral conjunctiva were used to repair the defects. Two horses regained functional vision in the affected eyes while a third had significant impairment. The fourth eye, which had an intense uveitis pre and postoperative, became phthisic and blind.
Regnier A, Martin C, Semin MO, Lienard E, Geffre A, Douet JY, Raymond-Letron I.An 18-month-old Arabian-English filly resident in southwest France was referred for evaluation of a conjunctival mass in the right eye (OD). A pink, solid, and mobile nodular formation, measuring approximately 1.2 × 0.8 cm was found under the superior nasal bulbar conjunctiva during an ophthalmic examination that was otherwise normal. The mass was surgically removed using a standing procedure. Cytological examination of fine-needle aspirates from the mass revealed a mixed eosinophilic-lymphocytic inflammation. Histological examination confirmed the dense and diffuse eosinophilic-lymphocyti...