Equine non-healing corneal ulcers: a retrospective evaluation of 57 cases (2001-2017).
Abstract: Non-healing corneal ulcers (NHCU) are a common problem in equine practice and several treatment options are available with different success and healing times. The aim of this retrospective study was to evaluate and to compare treatment protocols, clinical courses, corneal healing time and outcomes of NHCU. Methods: From December 2001 to December 2017, a total of 57 horses with NHCU were presented at the Vetmeduni Vienna. Recorded data included affected eye, signalment, clinical symptoms, season of diagnosis, treatment protocols, complications and corneal healing rate. Results: Sixty-three eyes were diagnosed with a NHCU. Follow-up information was available for 48/63 eyes. For those treated medically mean corneal healing time was 15.7 days (± SD 12.0). Medical treatment included topical antibiotics, antimycotics, cycloplegics, and systemic anti-inflammatory drugs. Twelve eyes received treatment with a poly-carboxymethylglucose-sulfate regenerating agent (Cacicol®; Thea Pharma GmbH, Wien, Austria). Other common additional treatments included debridement with an iodine drenched cotton tip (48 eyes; 76.2 %) and diamond burr debridement (30 eyes; 47.6 %). A bandage contact lens (BCL) was used for 10 eyes. Each eye received at least one additional treatment, although none of them led to a statistically significant alteration in healing time. Only usage of a BCL significantly increased healing time when compared to not using a BCL (p = 0.035). When all treatments failed, superficial keratectomy with placement of a conjunctival flap was performed. Secondary complications included stromal cellular infiltration, keratomycosis, keratomalacia, and corneal abscess formation. Conclusions: Results correlated with those previously described and thus demonstrated the difficulty and complexity of this disease. Further research is needed to determine an optimal treatment protocol for non-healing ulcers in horses. Conclusions: Since NHCUs are a commonly encountered problem in equine practice a reliable treatment protocol is required. This study reflects the problems with those ulcers and provides several protocols for possible treatments. Unassigned: Nicht oder schwer heilende Hornhautdefekte (NHHD) sind ein häufig auftretendes Problem in der Pferdepraxis. Es gibt dafür verschiedenste Behandlungsmethoden mit unterschiedlichem Erfolg und variierenden Heilungszeiträumen. Ziel dieser retrospektiven Studie war, Behandlungsmethoden, klinische Verläufe, korneale Heilungsdauer und Erfolgsraten bei NHHD zu untersuchen und zu vergleichen.eb Von Dezember 2001 bis Dezember 2017 wurden 57 Pferde mit einem NHHD an der Vetmeduni Vienna vorgestellt. Die aufgenommenen Patientendaten umfassten das betroffene Auge, Signalement, klinische Symptome, die Jahreszeit zum Zeitpunkt der Diagnose, Behandlungsprotokolle, Komplikationen und die korneale Heilungsdauer. Unassigned: Bei 63 Augen wurde die Diagnose NHHD gestellt. Verlaufskontrollen lagen bei 48/63 Augen vor. Medikamentös behandelte Augen wiesen eine Heilungsdauer von 15,7 Tagen (± SD 12,0) auf. Diese Behandlung beinhaltete die topische Gabe von Antibiotika, Antimykotika und Zykloplegika sowie systemisch verabreichte Antiphlogistika. Zwölf Augen wurden mit einem Poly-Carboxymethylglukose-Sulfat-Regenerationsmittel (Cacicol®; Thea Pharma GmbH, Wien, Austria) behandelt. Zusätzliche Behandlungsmethoden beinhalteten das Debridement mit einem in Jodlösung getränkten Stieltupfer (48 Augen; 76,2 %) und das Diamond Burr Debridement (30 Augen; 47,6 %). Bei 10 Augen wurde zusätzlich eine Schutzkontaktlinse eingesetzt. Jedes Auge wurde mit zumindest einer der oben genannten Methoden behandelt. Einzig die Verwendung einer Schutzkontaktlinse führte zu einer signifikant längeren Heilungsdauer als ohne (p = 0,035). Bei ausbleibendem Behandlungserfolg wurde eine oberflächliche Keratektomie mit Anbringen eines Bindehautlappens durchgeführt. Die häufigsten Komplikationen waren stromales zelluläres Infiltrat, die Entwicklung einer Keratomykose oder Keratomalazie und die Bildung eines kornealen Abszesses. Unassigned: Die Ergebnisse korrelieren mit den Daten publizierter Studien und demonstrieren dennoch die Problematik und Komplexität dieser Erkrankung. Weitere Forschung ist notwendig, um ein optimales Behandlungsschema für nicht heilende Hornhautdefekte bei Pferden zu entwickeln. Unassigned: Da NHHD ein häufig auftretendes Problem in der Pferdepraxis darstellen, ist ein verlässliches Behandlungsprotokoll dringend notwendig. Diese Studie zeigt die Probleme und Komplikationen mit diesen Ulzerationen auf und beschreibt zusätzlich verschiedene Behandlungsmethoden.
© Georg Thieme Verlag KG Stuttgart · New York.
Publication Date: 2020-04-23 PubMed ID: 32325498DOI: 10.1055/a-1124-2953Google Scholar: Lookup
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Summary
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This study is a retrospective evaluation of different treatment protocols and their outcomes for non-healing corneal ulcers in horses, common within veterinary practice. The study, conducted from 2001 to 2017, assesses 57 horses and reveals that there is no significant variation in healing time among the different treatments, except for the use of a bandage contact lens which increased healing time.
Study Details and Methods
- The study was carried out at Vetmeduni Vienna over 16 years, from December 2001 to December 2017. A total of 57 horses exhibiting non-healing corneal ulcers (NHCU) were assessed.
- Data collected for each case included the affected eye, the horse’s signals, clinical symptoms, season of diagnosis, treatment protocols, any complications, and the corneal healing rate.
Results
- A total of 63 eyes were diagnosed with NHCU from the 57 horses. Follow-up information was available for 48 of the 63 eyes.
- The average corneal healing time was 15.7 days for those treated medically. Medical treatment involved a combination of topical antibiotics, antimycotics, cycloplegics, and systemic anti-inflammatory drugs.
- Twelve eyes were treated with a poly-carboxymethylglucose-sulfate regenerating agent. Other prevalent additional treatments included debridement with an iodine-soaked cotton tip (used in 48 eyes) and diamond burr debridement (used in 30 eyes).
- Ten eyes received a bandage contact lens (BCL) as a part of the treatment. The use of a BCL significantly increased healing time compared to not using a BCL.
- When all treatments failed, a superficial keratectomy (surgical removal of corneal surface cells) with the placement of a conjunctival flap was performed. Notable secondary complications were stromal cellular infiltration, keratomycosis, keratomalacia, and corneal abscess formation.
Conclusions and Recommendations
- The study’s results were consistent with those found in previous studies, highlighting the complexity and difficulty in treating this condition in horses. It underscores the need for further research to establish an optimal treatment protocol for NHCU in horses.
- The study concludes that because non-healing corneal ulcers are commonly encountered in equine practice, a reliable treatment protocol is needed for effective management.
- The research provides several treatment options, from medical treatments to surgical interventions. However, it emphasizes that none of them significantly influences the healing time, with an exception for the use of a bandage contact lens, which increased healing time.
Cite This Article
APA
Prucha VJS, Tichy A, Nell B.
(2020).
Equine non-healing corneal ulcers: a retrospective evaluation of 57 cases (2001-2017).
Tierarztl Prax Ausg G Grosstiere Nutztiere, 48(2), 92-97.
https://doi.org/10.1055/a-1124-2953 Publication
Researcher Affiliations
- Department of Companion Animals and Horses, Vetmeduni Vienna.
- Department of Biomedical Sciences, Vetmeduni Vienna.
- Department of Companion Animals and Horses, Vetmeduni Vienna.
MeSH Terms
- Administration, Topical
- Animals
- Anti-Infective Agents / administration & dosage
- Corneal Ulcer / diagnosis
- Corneal Ulcer / therapy
- Corneal Ulcer / veterinary
- Debridement
- Female
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Male
- Mydriatics / administration & dosage
- Retrospective Studies
- Seasons
- Time Factors
- Treatment Outcome
Conflict of Interest Statement
The authors declare not to have any conflict of interest.
Citations
This article has been cited 1 times.- Casado-Santos A, González-Cubero E, González-Fernández ML, González-Rodríguez Y, García-Rodríguez MB, Villar-Suárez V. Equine Corneal Wound Healing Using Mesenchymal Stem Cell Secretome: Case Report. Animals (Basel) 2024 Jun 21;14(13).
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