FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Vet Ophthalmol / Clinical utility, dose determination, and safety of ocular c...
Veterinary ophthalmology2019; 23(2); 331-340; doi: 10.1111/vop.12730

Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study.

Abstract: To determine efficacy of contrast-enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Methods: Ocular B-mode and contrast-enhanced ultrasonography were performed bilaterally in nine sedated university-owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different dose. Qualitative blood flow and quantitative perfusion were analyzed. Heart and respiratory rates were monitored nonsedated, sedated, and during first and second minutes of CEUS. Results: Qualitative contrast enhancement (CE) was visible in 7/9 animals. Quantitative CE was measurable bilaterally in four horses, unilaterally in three individuals, and not detected in two animals. In all horses with unilateral CE, the positive eye received the higher dose. Fifteen mL dose resulted in significantly shorter time to peak than 10 mL (P < .05). Peak intensity, maximum signal increase, and corresponding area under the curve were significantly higher for 15 and 20 mL doses compared with 10 mL (P < .05). Uveal and retinal tissues were enhanced frequently. Twenty-five and 30 mL doses revealed no CE. Only sedation reduced heart rates significantly (P < .05). Clinically relevant changes in respiratory rates or adverse reactions following SF6 application were not observed. Conclusions: Contrast enhancement was in most instances dose-dependent. Fifteen mL appeared appropriate to assess equine ocular perfusion. The reliability in horses remains questionable; however, CEUS was well-tolerated.
© 2019 The Authors. Veterinary Ophthalmology published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Ophthalmologists.
Get Full Text
Publication Date: 2019-12-04 PubMed ID: 31799804PubMed Central: PMC7155076DOI: 10.1111/vop.12730Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The researchers conducted a pilot study to evaluate the effectiveness and safety of contrast-enhanced ultrasonography (CEUS) in assessing blood flow and perfusion in horses’ eyes. They varied the doses of sulfur hexafluoride used, and found that the procedure was generally safe and effective, though its reliability was questionable.

Methodology

  • The study involved nine university-owned horses, which were sedated during the process.
  • Ocular B-mode and contrast-enhanced ultrasonography were carried out on both eyes of each horse. Intravenous SonoVue® bolus injections of sulfur hexafluoride were administered in dosages varying between 5 and 30 mL.
  • The dose of sulfur hexafluoride each horse received was determined based on its bodyweight, with each eye within a single horse receiving a different dose.
  • All procedures were monitored, capturing heart and respiratory rates of the horses while sedated and during the first two minutes of CEUS.

Results

  • Visible contrast enhancement was observed in 7 out of 9 animals. While contrast enhancement was measurable in both eyes of four horses, it was only noticeable in one eye for three horses, and completely undetected in two horses.
  • In all the horses with one eye showing contrast enhancement, the eye that received the higher dose showed positive results.
  • The 15 mL dose resulted in a significantly shorter time to reach peak intensity compared to the 10 mL dose.
  • Peak intensity, maximum signal increase, and corresponding area under the curve were found to be significantly higher for 15 and 20 mL doses compared to the 10 mL dose.
  • The higher doses of 25 and 30 mL showed no visible contrast enhancement.
  • Sedation resulted in significant reduction in heart rates, while no clinically relevant changes in respiratory rates or adverse reactions were observed post SF6 application.

Conclusions

  • The study found that contrast enhancement was dose-dependent in most instances.
  • The 15 mL dose appeared to be appropriate for assessing blood flow and perfusion in the horses’ eyes.
  • Despite the general effectiveness of the procedure, the reliability of contrast-enhanced ultrasonography in horses remains questionable due to the variability in observed results.
  • Contrast-enhanced ultrasonography was well-tolerated by the horses, indicating its safety in assessing equine ocular blood flow and perfusion.

Cite This Article

APA
Blohm KO, Tichy A, Nell B. (2019). Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study. Vet Ophthalmol, 23(2), 331-340. https://doi.org/10.1111/vop.12730

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English
Volume: 23
Issue: 2
Pages: 331-340

Researcher Affiliations

Blohm, Klaas-Ole
  • Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.
Tichy, Alexander
  • Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria.
Nell, Barbara
  • Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.

MeSH Terms

  • Animals
  • Contrast Media / administration & dosage
  • Contrast Media / pharmacology
  • Drug Tapering
  • Eye / diagnostic imaging
  • Eye Diseases / diagnosis
  • Eye Diseases / veterinary
  • Female
  • Horse Diseases / diagnosis
  • Horses
  • Male
  • Pilot Projects
  • Sulfur Hexafluoride / administration & dosage
  • Sulfur Hexafluoride / pharmacology
  • Ultrasonography / methods
  • Ultrasonography / veterinary

Conflict of Interest Statement

The authors did not receive any direct or indirect funding for this study and have no conflicts of interests to declare.

References

This article includes 43 references
  1. Gilger BC. Advanced Imaging of the Equine Eye.. Vet Clin North Am Equine Pract 2017 Dec;33(3):607-626.
    pubmed: 28985984doi: 10.1016/j.cveq.2017.07.006google scholar: lookup
  2. Schaer BD. Ophthalmic emergencies in horses.. Vet Clin North Am Equine Pract 2007 May;23(1):49-65.
    pubmed: 17379109doi: 10.1016/j.cveq.2006.11.009google scholar: lookup
  3. Ramirez S, Tucker RL. Ophthalmic imaging.. Vet Clin North Am Equine Pract 2004 Aug;20(2):441-57.
    pubmed: 15271433doi: 10.1016/j.cveq.2004.04.004google scholar: lookup
  4. Ben-Shlomo G. The Equine Fundus.. Vet Clin North Am Equine Pract 2017 Dec;33(3):499-517.
    pubmed: 29103559doi: 10.1016/j.cveq.2017.08.003google scholar: lookup
  5. Scotty NC, Cutler TJ, Brooks DE, Ferrell E. Diagnostic ultrasonography of equine lens and posterior segment abnormalities.. Vet Ophthalmol 2004 Mar-Apr;7(2):127-39.
    pubmed: 14982592doi: 10.1111/j.1463-5224.2004.04009.xgoogle scholar: lookup
  6. Gallhoefer NS, Bentley E, Ruetten M, Grest P, Haessig M, Kircher PR, Dubielzig RR, Spiess BM, Pot SA. Comparison of ultrasonography and histologic examination for identification of ocular diseases of animals: 113 cases (2000-2010).. J Am Vet Med Assoc 2013 Aug 1;243(3):376-88.
    pubmed: 23865880doi: 10.2460/javma.243.3.376google scholar: lookup
  7. Seiler GS, Campbell N, Nixon B, Tsuruta JK, Dayton PA, Jennings S, Redding WR, Lustgarten M. FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES.. Vet Radiol Ultrasound 2016 May;57(3):282-9.
    pubmed: 26765518doi: 10.1111/vru.12333google scholar: lookup
  8. Hong S, Park S, Lee D, Cha A, Kim D, Choi J. Contrast-enhanced ultrasonography for evaluation of blood perfusion in normal canine eyes.. Vet Ophthalmol 2019 Jan;22(1):31-38.
    pubmed: 29521438doi: 10.1111/vop.12562google scholar: lookup
  9. Blohm KO, Hittmair KM, Tichy A, Nell B. Quantitative, noninvasive assessment of intra- and extraocular perfusion by contrast-enhanced ultrasonography and its clinical applicability in healthy dogs.. Vet Ophthalmol 2019 Nov;22(6):767-777.
    pmc: PMC6899557pubmed: 30773789doi: 10.1111/vop.12648google scholar: lookup
  10. Bertolotto M, Serafini G, Sconfienza LM, Lacelli F, Cavallaro M, Coslovich A, Tognetto D, Cova MA. The use of CEUS in the diagnosis of retinal/choroidal detachment and associated intraocular masses - preliminary investigation in patients with equivocal findings at conventional ultrasound.. Ultraschall Med 2014 Apr;35(2):173-80.
    pubmed: 23450377doi: 10.1055/s-0032-1330321google scholar: lookup
  11. Han SS, Chang SK, Yoon JH, Lee YJ. The use of contrast-enhanced color Doppler ultrasound in the differentiation of retinal detachment from vitreous membrane.. Korean J Radiol 2001 Oct-Dec;2(4):197-203.
    pmc: PMC2718121pubmed: 11754326doi: 10.3348/kjr.2001.2.4.197google scholar: lookup
  12. Sconfienza LM, Lacelli F, Ardemagni A, Perrone N, Bertolotto M, Padolecchia R, Serafini G. High-resolution, three-dimensional, and contrast-enhanced ultrasonographic findings in diseases of the eye().. J Ultrasound 2010 Dec;13(4):143-9.
    pmc: PMC3552659pubmed: 23396709doi: 10.1016/j.jus.2010.10.002google scholar: lookup
  13. Labruyere JJ, Hartley C, Holloway A. Contrast-enhanced ultrasonography in the differentiation of retinal detachment and vitreous membrane in dogs and cats.. J Small Anim Pract 2011 Oct;52(10):522-30.
    pubmed: 21967099doi: 10.1111/j.1748-5827.2011.01099.xgoogle scholar: lookup
  14. Ferreira TAC, Fornazari G, Saldanha A, Lunardeli B, Moore BA, Montiani-Ferreira F. The use of sulfur hexafluoride microbubbles for contrast-enhanced ocular ultrasonography of the pecten oculi in birds.. Vet Ophthalmol 2019 Jul;22(4):423-429.
    pubmed: 30109756doi: 10.1111/vop.12608google scholar: lookup
  15. Hirokawa T, Nishikage T, Moroe T, Kajima M, Hayashi M, Naito T, Yamane S, Shiota H. Visualization of uveal perfusion by contrast-enhanced harmonic ultrasonography at a low mechanical index: a pilot animal study.. J Ultrasound Med 2002 Mar;21(3):299-307.
    pubmed: 11883541doi: 10.7863/jum.2002.21.3.299google scholar: lookup
  16. Kang SJ, Zhang Q, Patel SR, Berezovsky D, Yang H, Wang Y, Grossniklaus HE. In vivo high-frequency contrast-enhanced ultrasonography of choroidal melanoma in rabbits: imaging features and histopathologic correlations.. Br J Ophthalmol 2013 Jul;97(7):929-33.
    pmc: PMC3863377pubmed: 23645822doi: 10.1136/bjophthalmol-2013-303343google scholar: lookup
  17. Zhang Q, Yang H, Kang SJ, Wang Y, Wang GD, Coulthard T, Grossniklaus HE. In vivo high-frequency, contrast-enhanced ultrasonography of uveal melanoma in mice: imaging features and histopathologic correlations.. Invest Ophthalmol Vis Sci 2011 Apr;52(5):2662-8.
    pmc: PMC3088556pubmed: 21245408doi: 10.1167/iovs.10-6794google scholar: lookup
  18. Scherrer NM, Lassaline M, Engiles J. Ocular and periocular hemangiosarcoma in six horses.. Vet Ophthalmol 2018 Jul;21(4):432-437.
    pubmed: 29111617doi: 10.1111/vop.12529google scholar: lookup
  19. Knottenbelt DC, Hetzel U, Roberts V. Primary intraocular primitive neuroectodermal tumor (retinoblastoma) causing unilateral blindness in a gelding.. Vet Ophthalmol 2007 Nov-Dec;10(6):348-56.
    pubmed: 17970995doi: 10.1111/j.1463-5224.2007.00567.xgoogle scholar: lookup
  20. Pirie CG, LoPinto AJ, Tenney WA. Comparison of angiographic dyes and injection techniques for ocular anterior segment angiography in horses.. Am J Vet Res 2018 May;79(5):562-567.
    pubmed: 29688789doi: 10.2460/ajvr.79.5.562google scholar: lookup
  21. Piscaglia F, Nolsøe C, Dietrich CF, Cosgrove DO, Gilja OH, Bachmann Nielsen M, Albrecht T, Barozzi L, Bertolotto M, Catalano O, Claudon M, Clevert DA, Correas JM, D'Onofrio M, Drudi FM, Eyding J, Giovannini M, Hocke M, Ignee A, Jung EM, Klauser AS, Lassau N, Leen E, Mathis G, Saftoiu A, Seidel G, Sidhu PS, ter Haar G, Timmerman D, Weskott HP. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications.. Ultraschall Med 2012 Feb;33(1):33-59.
    pubmed: 21874631doi: 10.1055/s-0031-1281676google scholar: lookup
  22. McMullen RJ Jr, Fischer BM. Medical and Surgical Management of Equine Recurrent Uveitis.. Vet Clin North Am Equine Pract 2017 Dec;33(3):465-481.
    pubmed: 28985983doi: 10.1016/j.cveq.2017.07.003google scholar: lookup
  23. Hendrix DVH. Diseases and surgery of the canine anterior uvea. Veterinary Ophthalmology 2013:1146‐1198.
  24. Bargellini P, Orlandi R, Paloni C, Rubini G, Fonti P, Peterson ME, Rishniw M, Boiti C. EVALUATION OF CONTRAST-ENHANCED ULTRASONOGRAPHY AS A METHOD FOR DETECTING GALLBLADDER NECROSIS OR RUPTURE IN DOGS.. Vet Radiol Ultrasound 2016 Nov;57(6):611-620.
    pubmed: 27575865doi: 10.1111/vru.12404google scholar: lookup
  25. Rossi F, Leone VF, Vignoli M, Laddaga E, Terragni R. Use of contrast-enhanced ultrasound for characterization of focal splenic lesions.. Vet Radiol Ultrasound 2008 Mar-Apr;49(2):154-64.
    pubmed: 18418997doi: 10.1111/j.1740-8261.2008.00343.xgoogle scholar: lookup
  26. Ohlerth S, Rüefli E, Poirier V, Roos M, Kaser-Hotz B. Contrast harmonic imaging of the normal canine spleen.. Vet Radiol Ultrasound 2007 Sep-Oct;48(5):451-6.
    pubmed: 17899981doi: 10.1111/j.1740-8261.2007.00277.xgoogle scholar: lookup
  27. Stock E, Vanderperren K, Haers H, Duchateau L, Hesta M, Saunders JH. Quantitative Differences Between the First and Second Injection of Contrast Agent in Contrast-Enhanced Ultrasonography of Feline Kidneys and Spleen.. Ultrasound Med Biol 2017 Feb;43(2):500-504.
    pubmed: 27746009doi: 10.1016/j.ultrasmedbio.2016.09.013google scholar: lookup
  28. Schweiger H, Ohlerth S, Gerber B. Contrast-enhanced ultrasound of both kidneys in healthy, non-anaesthetized cats.. Acta Vet Scand 2015 Nov 25;57:80.
    pmc: PMC4660782pubmed: 26608541doi: 10.1186/s13028-015-0172-5google scholar: lookup
  29. Quarta M, Pugliese M, Ragusa M. Contrast‐enhanced ultrasonography (CEUS) in feline normal and neoplastic uvea (abstract). Annual Scientific Meeting of the European College of Veterinary Ophthalmologists Budapest (Hungary).2016;Proceedings:10.
  30. Torres A, Koskinen SK, Gjertsen H, Fischler B. Contrast-enhanced ultrasound using sulfur hexafluoride is safe in the pediatric setting.. Acta Radiol 2017 Nov;58(11):1395-1399.
    pubmed: 28173725doi: 10.1177/0284185117690423google scholar: lookup
  31. Seiler GS, Brown JC, Reetz JA, Taeymans O, Bucknoff M, Rossi F, Ohlerth S, Alder D, Rademacher N, Drost WT, Pollard RE, Travetti O, Pey P, Saunders JH, Shanaman MM, Oliveira CR, O'Brien RT, Gaschen L. Safety of contrast-enhanced ultrasonography in dogs and cats: 488 cases (2002-2011).. J Am Vet Med Assoc 2013 May 1;242(9):1255-9.
    pubmed: 23600783doi: 10.2460/javma.242.9.1255google scholar: lookup
  32. Piscaglia F, Bolondi L. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations.. Ultrasound Med Biol 2006 Sep;32(9):1369-75.
    pubmed: 16965977doi: 10.1016/j.ultrasmedbio.2006.05.031google scholar: lookup
  33. Nyman HT, Kristensen AT, Kjelgaard-Hansen M, McEvoy FJ. Contrast-enhanced ultrasonography in normal canine liver. Evaluation of imaging and safety parameters.. Vet Radiol Ultrasound 2005 May-Jun;46(3):243-50.
    pubmed: 16050284doi: 10.1111/j.1740-8261.2005.00034.xgoogle scholar: lookup
  34. Zhai HY, Liang P, Yu J, Cao F, Kuang M, Liu FY, Liu FY, Zhu XY. Comparison of Sonazoid and SonoVue in the Diagnosis of Focal Liver Lesions: A Preliminary Study.. J Ultrasound Med 2019 Sep;38(9):2417-2425.
    pubmed: 30680779doi: 10.1002/jum.14940google scholar: lookup
  35. Hopster K, Bienert‐Zeit A, Hopster‐Iversen C. Influence of ketamine or midazolam in combination with a romifidine‐butorphanol‐constant rate infusion on sedation quality during tooth extraction in standing horses. Pferdeheilkunde 2013;29:220‐227.
  36. Schauvliege S, Cuypers C, Michielsen A, Gasthuys F, Gozalo-Marcilla M. How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm.. Vet Anaesth Analg 2019 Jan;46(1):4-13.
    pubmed: 30528671doi: 10.1016/j.vaa.2018.08.005google scholar: lookup
  37. Andreani V, Di Girolamo N, Guandalini A. Accurary of contrast enhanced ultrasonography (CEUS) and color doppler (CFM) to diagnose neoplastic intraocular masses in small animals: preliminary results (abstract). Annual Scientific Meeting of the European College of Veterinary Ophthalmologists Budapest (Hungary).2016;Proceedings:11.
  38. Yang WL, Wei WB, Li DJ. Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound.. Chin Med J (Engl) 2012 Dec;125(24):4440-4.
    pubmed: 23253716
  39. Carmalt JL, Montgomery J. INTRAARTERIAL INJECTION OF IODINATED CONTRAST MEDIUM FOR CONTRAST ENHANCED COMPUTED TOMOGRAPHY OF THE EQUINE HEAD.. Vet Radiol Ultrasound 2015 Jul-Aug;56(4):384-90.
    pubmed: 25782997doi: 10.1111/vru.12252google scholar: lookup
  40. Aharonson-Raz K, Singh B. Pulmonary intravascular macrophages and endotoxin-induced pulmonary pathophysiology in horses.. Can J Vet Res 2010 Jan;74(1):45-9.
    pmc: PMC2801311pubmed: 20357958
  41. Brain JD, Molina RM, DeCamp MM, Warner AE. Pulmonary intravascular macrophages: their contribution to the mononuclear phagocyte system in 13 species.. Am J Physiol 1999 Jan;276(1):L146-54.
    pubmed: 9887067doi: 10.1152/ajplung.1999.276.1.l146google scholar: lookup
  42. Atwal OS, Minhas KJ. In vivo interaction of cationised ferritin with the surface coat and endocytosis by pulmonary intravascular macrophages: a tracer kinetic study.. J Anat 1992 Oct;181 ( Pt 2)(Pt 2):313-25.
    pmc: PMC1259726pubmed: 1295869
  43. England GC, Clarke KW. Alpha 2 adrenoceptor agonists in the horse--a review.. Br Vet J 1996 Nov;152(6):641-57.
    pubmed: 8979422doi: 10.1016/s0007-1935(96)80118-7google scholar: lookup

Citations

This article has been cited 3 times.
  1. Wafy MN, Hassan EA, Ahmed KA, Aboelmaaty AM, Abu-Seida AM. Ultrasonographic and histopathologic features associated with common ocular diseases in donkeys (Equus asinus). Vet Res Commun 2023 Sep;47(3):1479-1491.
    doi: 10.1007/s11259-023-10102-4pubmed: 36941479google scholar: lookup
  2. Zhou Q, Wu H, Chen J, Cai Q, Chen Q, Feng L, Liu X. Contrast-enhanced ultrasound characteristics in orbital cavernous venous malformation. Exp Ther Med 2025 Jul;30(1):137.
    doi: 10.3892/etm.2025.12887pubmed: 40462858google scholar: lookup
  3. Bracco C, Gloria A, Contri A. Ultrasound-Based Technologies for the Evaluation of Testicles in the Dog: Keystones and Breakthroughs. Vet Sci 2023 Dec 1;10(12).
    doi: 10.3390/vetsci10120683pubmed: 38133235google scholar: lookup
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.