Clinical appearances, healing patterns, risk factors, and outcomes of horses with fungal keratitis: 53 cases (1978-1996).
Abstract: To compare initial clinical appearances, healing mechanisms, risk factors, and outcomes of horses with fungal keratitis. Methods: Retrospective analysis. Methods: 52 horses (53 eyes) with fungal keratitis. Methods: Medical records and clinical photographs of eyes were reviewed. Keratomycoses were categorized on the basis of clinical appearance at initial examination and pattern of healing. Results: Five distinct forms of mycotic keratitis were recognized. Of 53 affected eyes, 34 (64%) retained sight and had varying degrees of corneal scarring after treatment, 6 (11%) had a cosmetic appearance but were blind, and 13 (25%) were enucleated. Bacterial-like ulcers were the most frequent type and the most difficult for predicting outcome. Eyes affected by superficial fungal keratitis were likely to be chronically infected and to require debridement and extended treatment but usually healed with minimal scarring. Keratomycosis with a surrounding furrow resulted in a grave prognosis. Aspergillus organisms were isolated from 9 of 10 such eyes. Cake-frosting material was a positive prognostic sign. Fungal corneal stromal abscesses tended to be caused by yeast. Conclusions: This information will aid practitioners in recognizing various forms of fungal keratitis and guide them when making therapeutic decisions and prognoses for affected horses.
Publication Date: 1998-07-10 PubMed ID: 9656035
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- Journal Article
Summary
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The research discusses the clinical appearances, healing patterns, risk factors, and outcomes of horses affected by fungal keratitis. They examined the medical records and clinical images of 53 cases from 1978-1996.
Methodology
- The researchers conducted a retrospective analysis of 52 horses, totaling 53 eyes, that had been diagnosed with fungal keratitis.
- The medical records and clinical pictures of the affected eyes were thoroughly reviewed.
- The instances of keratomycosis, a fungal infection of the cornea, were then classified according to their clinical appearance during the initial examination and their healing pattern.
Results and Discussion
- Research identified five distinct forms of mycotic keratitis.
- Out of 53 affected eyes, it was found that 34 (64%) retained visual abilities and had varying levels of corneal scarring after undergoing treatment.
- Six (11%) of the eyes had a cosmetic appearance but were actually blind, while 13 (25%) had to be enucleated or surgically removed due to severe damage or disease.
- Eyes with bacterial-like ulcers were considered the most common type but also posed significant challenges in predicting outcomes.
- Superficial fungal keratitis often led to chronic infections requiring extended treatment and corneal debridement, but they generally healed with minimum scarring.
- On the other hand, keratomycosis surrounded by a furrow was found to carry a severe prognosis, with Aspergillus species being the causative organisms for 9 out of 10 such cases.
- Presence of cake-frosting material in the eye was taken as a positive sign in terms of prognosis.
- Fungal corneal stromal abscesses, an infection of the stromal layer of the cornea, were likely to be caused by yeast infections.
Conclusions
- This study provides valuable insights on different forms of fungal keratitis in horses, helping practitioners better recognize, treat and predict outcomes for the condition.
Cite This Article
APA
Gaarder JE, Rebhun WC, Ball MA, Patten V, Shin S, Erb H.
(1998).
Clinical appearances, healing patterns, risk factors, and outcomes of horses with fungal keratitis: 53 cases (1978-1996).
J Am Vet Med Assoc, 213(1), 105-112.
Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853-6401, USA.
MeSH Terms
- Abscess / etiology
- Abscess / therapy
- Abscess / veterinary
- Animals
- Blindness / epidemiology
- Blindness / etiology
- Blindness / veterinary
- Cicatrix / epidemiology
- Cicatrix / etiology
- Cicatrix / veterinary
- Corneal Stroma
- Debridement / veterinary
- Eye Enucleation / veterinary
- Eye Infections, Fungal / epidemiology
- Eye Infections, Fungal / pathology
- Eye Infections, Fungal / veterinary
- Female
- Horse Diseases / epidemiology
- Horse Diseases / etiology
- Horse Diseases / pathology
- Horses
- Keratitis / epidemiology
- Keratitis / pathology
- Keratitis / veterinary
- Male
- Photography
- Prognosis
- Retrospective Studies
- Risk Factors
Citations
This article has been cited 13 times.- 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 Sep;47(3):1641-1651.
- Hisey EA, Martins BC, Donnelly CG, Cassano JM, Katzman SA, Murphy CJ, Thomasy SM, Leonard BC. Identification of putative orthologs of clinically relevant antimicrobial peptides in the equine ocular surface and amniotic membrane. Vet Ophthalmol 2023 Apr;26 Suppl 1(Suppl 1):125-133.
- Tahoun A, Elnafarawy HK, Elmahallawy EK, Abdelhady A, Rizk AM, El-Sharkawy H, Youssef MA, El-Khodery S, Ibrahim HMM. Epidemiological and Molecular Investigation of Ocular Fungal Infection in Equine from Egypt. Vet Sci 2020 Sep 8;7(3).
- Lores M, Rakestraw P, De Rijck M, Yarbrough T. Use of autologous fascia lata graft to repair a complex corneal ulcer in a mare. Ir Vet J 2020;73:7.
- Tamura N, Okano A, Kuroda T, Niwa H, Kusano K, Matsuda Y, Fukuda K, Mita H, Nagata S. Utility of systemic voriconazole in equine keratomycosis based on pharmacokinetic-pharmacodynamic analysis of tear fluid following oral administration. Vet Ophthalmol 2020 Jul;23(4):640-647.
- Flores MM, Del Piero F, Habecker PL, Langohr IM. A retrospective histologic study of 140 cases of clinically significant equine ocular disorders. J Vet Diagn Invest 2020 May;32(3):382-388.
- Knickelbein KE, Luethy D, Thomasy SM, Reilly C, Strom AR, Lassaline ME. Equine eosinophilic keratoconjunctivitis in California: retrospective study of 47 eyes from 29 cases (1993-2017). Vet Ophthalmol 2019 Jul;22(4):510-519.
- Galera PD, Brooks DE. Optimal management of equine keratomycosis. Vet Med (Auckl) 2012;3:7-17.
- Elad D, Segal E. Diagnostic Aspects of Veterinary and Human Aspergillosis. Front Microbiol 2018;9:1303.
- Sandmeyer LS, Bauer BS, Robinson K, Grahn BH. Diagnostic ophthalmology. Can Vet J 2014 Mar;55(3):281-3.
- Reed Z, Thomasy SM, Good KL, Maggs DJ, Magdesian KG, Pusterla N, Hollingsworth SR. Equine keratomycoses in California from 1987 to 2010 (47 cases). Equine Vet J 2013 May;45(3):361-6.
- Cullen CL, Grahn BH. Diagnostic ophthalmology. Corneal ulcer with severe secondary anterior uveitis in a pony. Can Vet J 2000 Nov;41(11):887-9.
- Hartley C. Treatment of corneal ulcers: what are the medical options?. J Feline Med Surg 2010 May;12(5):384-97.
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