Corneal Ulcers in Critically Ill Foals in Intensive Care: Case Series of Standard Treatment and Corneal Cross-Linking.
Abstract: Riboflavin/UV-A corneal cross-linking (CXL) has been applied to treat corneal ulcers in adult horses, but its use in critically ill neonatal foals has not been described. Five cases of hospitalized, critically ill neonatal foals that were in intensive care with corneal ulcers, the ophthalmic treatment, and their outcome up to 1 year are described. A single treatment of CXL phototherapy was performed in three of five foals (five eyes). The application of a riboflavin ophthalmic solution for 20 minutes was followed by the UV-A light irradiation at 30 mW/cm2 for 3 minutes. Topical antibiotic administration was withdrawn after CXL. Two other foals received standard treatment. Descriptions of ocular lesions, fluorescein staining, and photographic documentation were recorded. The visual outcome, corneal transparency, and aesthetics, as well as healing time were evaluated in the follow-up. The frequency of topical medication considerably decreased in cases treated with CXL. Corneal opacity and pain decreased within 3 days following CXL. In the foals treated with CXL, the ulcers healed (fluorescein stain negative) in 24, 28, and 35 days after the onset of clinical signs and 10, 15, and 21, after CXL. No fibrosis or corneal scars were found in the cases treated with CXL. The two standard treatment cases healed after 26 and 36 days respectively. Corneal cross-linking may be an additional or alternative treatment of corneal ulcers in critically ill neonatal foals and may reduce the use of antibiotics.
Copyright © 2023 Elsevier Inc. All rights reserved.
Publication Date: 2023-08-23 PubMed ID: 37625627DOI: 10.1016/j.jevs.2023.104910Google Scholar: Lookup
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Summary
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This research investigates the use of riboflavin/UV-A corneal cross-linking (CXL) in treating corneal ulcers in critically ill neonatal foals. The results showed that CXL is potentially an effective alternative treatment for corneal ulcers, reducing healing time and the need for antibiotics.
Study Overview
- This study evaluated the use of riboflavin/UV-A corneal cross-linking (CXL) to treat corneal ulcers in five critically ill neonatal foals admitted in intensive care.
- The investigation involved the application of riboflavin ophthalmic solution for 20 minutes, followed by UV-A light irradiation at 30 mW/cm2 for 3 minutes.
- Two of the five foals received standard treatment, while the rest were treated with CXL. The use of antibiotics was stopped after applying CXL.
- Data about the ocular lesions, fluorescein staining, photographic documentation, visual outcome, corneal transparency, aesthetics, and healing time were recorded and evaluated in the follow-up.
Findings
- The results showed that the frequency of using topical medication significantly decreased in cases treated with CXL.
- Corneal opacity and pain in the foals treated with CXL reduced within three days after the treatment.
- The ulcers healed (marked by fluorescein stain turning negative) in 24, 28, and 35 days after the onset of clinical signs, and 10, 15, and 21 days after CXL.
- No fibrosis or corneal scars were found in the foals treated with CXL.
- The foals that received standard treatment healed after 26 and 36 days respectively.
Implications and Conclusion
- The study suggests that corneal cross-linking might be an additional or alternative treatment for corneal ulcers in critically ill neonatal foals.
- This new treatment method could also reduce the use of antibiotics, which is beneficial for preventing antibiotic resistance.
- The results indicate that CXL is potentially an effective alternative treatment for corneal ulcers, reducing the healing time and the need for continued medication.
Cite This Article
APA
Imposimato I, Mariella J, Freccero F, Gialletti R.
(2023).
Corneal Ulcers in Critically Ill Foals in Intensive Care: Case Series of Standard Treatment and Corneal Cross-Linking.
J Equine Vet Sci, 130, 104910.
https://doi.org/10.1016/j.jevs.2023.104910 Publication
Researcher Affiliations
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy. Electronic address: ilaria.imposimato2@unibo.it.
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy.
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Ozzano dell'Emilia, Bologna, Italy.
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy.
MeSH Terms
- Horses
- Animals
- Corneal Ulcer / drug therapy
- Corneal Ulcer / veterinary
- Corneal Cross-Linking / veterinary
- Photosensitizing Agents / therapeutic use
- Ulcer / drug therapy
- Ulcer / veterinary
- Critical Illness / therapy
- Riboflavin / therapeutic use
- Anti-Bacterial Agents / therapeutic use
- Critical Care
- Fluoresceins / therapeutic use
- Horse Diseases / drug therapy
Conflict of Interest Statement
Declaration of Competing Interest None. A/uthors don\'t have financial or personal relationships with people or organizations that could inappropriately influence the content of the paper.
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