Efficacy and safety of suprachoroidal triamcinolone injection in horses with poorly responsive equine recurrent uveitis.
Abstract: Equine recurrent uveitis (ERU), a chronic, immune-mediated intraocular inflammatory disease, is a common cause of blindness in horses. The severity and recurrent nature of ERU makes it difficult to treat with current therapeutics leading to a poor visual prognosis. The suprachoroidal space (SCS), a potential space between the choroid and sclera surrounding the ocular posterior segment, offers a promising alternative site for drug application to the eye. Corticosteroid administration within this space is hypothesized to be safe and effective at controlling intraocular inflammation, especially in horses with poorly responsive ERU. Methods: Horses with active, poorly responsive ERU. Methods: A retrospective study was performed with 29 horses (36 total eyes) that received SCS injection of triamcinolone acetonide (TA) with ERU not well controlled with standard uveitis treatment. A standardized ocular inflammation score (OIS) was used to assess inflammation at the time of injection and at follow-ups. Results: Standardized OIS revealed a significant decrease in ocular inflammation over time after SCS TA administration (p < .004). Adverse effects after injections occurred in <20% of the horses at follow-up, but some of these effects were attributed to chronic inflammation prior to effective treatment, long-term topical corticosteroid use, or complications from hospitalization rather than the SCS injections. Most horses (86.7%) in this study remained visual greater than 3 months after SCS injection. Conclusions: Based on these results, SCS TA injections appear to be a safe and possible effective treatment modality for managing poorly responsive ERU; further clinical study is warranted.
© 2021 American College of Veterinary Ophthalmologists.
Publication Date: 2021-03-31 PubMed ID: 33788369DOI: 10.1111/vop.12887Google Scholar: Lookup
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- Journal Article
Summary
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This research article explores the safety and effectiveness of administering the corticosteroid triamcinolone acetonide (TA) to horses via injection into the suprachoroidal space (SCS) as a treatment for equine recurrent uveitis (ERU), a chronic inflammatory eye condition that often results in blindness. The study finds that this innovative method of drug application may help reduce ocular inflammation and is considered safe for use.
Background on Equine Recurrent Uveitis and Suprachoroidal Space
- The paper unfolds with a brief background on ERU, which is a chronic, immune-mediated intraocular inflammatory disease prominently seen in horses. It’s one of the major causes of blindness in the equine community.
- The severity and repetitive nature of ERU make it hard to control with the existing treatment techniques, often resulting in a poor visual prognosis for the affected horses.
- The focus then shifts to the suprachoroidal space (SCS), a potential space found between the choroid and sclera, enclosing the ocular posterior segment, which is suggested as a promising site for applying drugs to the eye.
Methodology
- The researchers performed a retrospective study involving 29 horses (corresponding to 36 eyes) with active, poorly responsive ERU. These horses had already undergone standard uveitis treatment but without manifesting significant improvement.
- The horses were subjected to SCS injections of triamcinolone acetonide (TA), after which they were regularly monitored.
- The team used a standardized ocular inflammation score (OIS) to assess inflammation at the time of injection and at consistent follow-up intervals.
Results
- The standardized OIS revealed a significant drop in ocular inflammation in the horses over time, following the SCS TA administration. The decrease was statistically significant, with a p-value of less than .004, which indeed verifies it was unlikely due to random chance.
- Upon follow-up post-injections, less than 20% of the horses experienced adverse effects. However, these results were associated with chronic inflammation before effective treatment, long-term usage of topical corticosteroids, or complications stemming from hospitalization, but not directly linked to the SCS injections.
- Most horses in the study (86.7% to be exact) remained visual for more than 3 months post SCS injection.
Conclusions
- The research article concludes by advocating that the SCS TA injections seem to be a safe and possibly effective treatment method for dealing with poorly responsive ERU.
- However, the researchers highlight the need for further clinical studies to consolidate the findings and to build a stronger case for implementing such treatment procedures in routine medical care.
Cite This Article
APA
Gagnon NA, Hartley C, Gilger BC.
(2021).
Efficacy and safety of suprachoroidal triamcinolone injection in horses with poorly responsive equine recurrent uveitis.
Vet Ophthalmol, 24(3), 308-312.
https://doi.org/10.1111/vop.12887 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
- Langford Clinical Veterinary Service, University of Bristol, Bristol, UK.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
MeSH Terms
- Animals
- Anti-Inflammatory Agents / administration & dosage
- Anti-Inflammatory Agents / therapeutic use
- Choroid
- Female
- Horse Diseases / drug therapy
- Horses
- Injections / veterinary
- Male
- Records / veterinary
- Recurrence
- Retrospective Studies
- Treatment Outcome
- Triamcinolone / administration & dosage
- Triamcinolone / therapeutic use
- Uveitis / drug therapy
- Uveitis / veterinary
Grant Funding
- NC State Veterinary Scholars Program
References
This article includes 12 references
- Gerding JC, Gilger BC. Prognosis and impact of equine recurrent uveitis. Equine Vet J 2016;48(3):290-298.
- Dwyer AE, Crockett RS, Kalsow CM. Association of leptospiral seroreactivity and breed with uveitis and blindness in horses: 372 cases (1986-1993). J Am Vet Med Assoc 1995;207(10):1327-1331.
- Gilger BC, Hollingsworth SR. Diseases of the uvea, uveitis, and recurrent uveitis. .
- Gilger BC, Abarca EM, Salmon JH, Patel S. Treatment of acute posterior uveitis in a porcine model by injection of triamcinolone acetonide into the suprachoroidal space using microneedles. Invest Ophthalmol Vis Sci 2013;54(4):2483-2492.
- Goldstein DA, Do D, Noronha G, Kissner JM, Srivastava SK, Nguyen QD. Suprachoroidal corticosteroid administration: a novel route for local treatment of noninfectious uveitis. Transl Vis Sci Technol 2016;5(6):14.
- Chen M, Li X, Liu J, Han Y, Cheng L. Safety and pharmacodynamics of suprachoroidal injection of triamcinolone acetonide as a controlled ocular drug release model. J Control Release 2015;203:109-117.
- Eaton J, Miller P, Bentley E, Thomasy SM, Murphy C. Standardized scoring of ocular findings in the context of drug and device development programs. 2018:169-204.
- Stoppini R, Gilger BC. Equine ocular examination basic techniques. .
- Kadam RS, Williams J, Tyagi P, Edelhauser HF, Kompella UB. Suprachoroidal delivery in a rabbit ex vivo eye model: influence of drug properties, regional differences in delivery, and comparison with intravitreal and intracameral routes. Mol Vis 2013(19):1198-1210.
- Abarca EM, Salmon JH, Gilger BC. Effect of choroidal perfusion on ocular tissue distribution after intravitreal or suprachoroidal injection in an arterially perfused ex vivo pig eye model. J Ocul Pharmacol Ther 2013;29(8):715-722.
- Olsen TW, Feng X, Wabner K, Csaky K, Pambuccian S, Douglas CJ. Pharmacokinetics of pars plana intravitreal injections versus microcannula suprachoroidal injections of bevacizumab in a porcine model. Investig Ophthalmol Vis Sci 2011;52(7):4749-4756.
- Seiler GS, Salmon JH, Mantuo R, Feingold S, Dayton PA, Gilger BC. Effect and distribution of contrast medium after injection into the anterior suprachoroidal space in ex vivo eyes. Invest Ophthalmol Vis Sci 2011;52(8):5730-5736.
Citations
This article has been cited 3 times.- Long Y, Qi J, Zhang W, Qin H, Yao K. Advances in RPGR gene therapy for X‑linked retinitis pigmentosa: From preclinical insights to clinical application (Review). Int J Mol Med 2026 Mar;57(3).
- Hejri A, Bowland II, Nickerson JM, Prausnitz MR. Suprachoroidal Delivery in Rats and Guinea Pigs Using a High-Precision Microneedle Injector. Transl Vis Sci Technol 2023 Mar 1;12(3):31.
- Wollanke B, Gerhards H, Ackermann K. Infectious Uveitis in Horses and New Insights in Its Leptospiral Biofilm-Related Pathogenesis. Microorganisms 2022 Feb 7;10(2).
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