FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary ophthalmology2025; doi: 10.1111/vop.70027

Infracyanine Green-Based Photodynamic Therapy for Immune-Mediated Keratitis in Horses.

Abstract: To describe infracyanine green-based photodynamic therapy (InfraCG-PDT) and evaluate outcomes in horses with immune-mediated keratitis (IMMK). Methods: Medical records from 2014 to 2020 from the Equine Clinic Munich-Riem, Germany, and Auburn University Equine Ophthalmology Service identified horses diagnosed with IMMK following ophthalmic examination that had undergone InfraCG-PDT. Methods: Multiple intrastromal injections of EmunDo (InfraCG, A.R.C. Laser, Nuernberg, Germany) within an affected quadrant or the entire cornea were treated with diffuse diode laser energy (FOX A.R.C., Laser, Nuernberg, Germany, 500 mW at 30s cycles) irradiation between 75 J (J, quadrant) and 300 J (entire cornea). Results: Fifty-one eyes (22 OS, 19 OD, 10 OU) from 47 horses were included (22 geldings, 20 mares, and 5 stallions) from 15 breeds aged between 4 and 29 years (median 14 years). Individual quadrants (28/51 eyes, 54.9%) or the entire cornea (23/51 eyes, 45.1%) were treated. Complications were defined as immediate: intrastromal fracture (4/51 eyes, 7.8%), intracameral InfraCG (7/51 eyes, 13.7%), and an epithelial blister (1/51 eyes, 1.9%) or short term: prolonged dye retention (51/51 eyes, 100%, with gradual reduction over a 12-week period) and superficial corneal ulceration (15/51 eyes, 29.4%). Globe threatening ulcers (3/51 eyes, 5.9%) resolved without significant complications. IMMK remained inactive (controlled or managed with improvement in ocular lesions) in 31/40 horses (77.5%) during follow-up (mean 223.0 ± 269.3 days; range 14-1095 days), 4/40 horses (10.0%) required additional treatment, and 5/40 horses (12.5%) were lost to follow-up. Conclusions: InfraCG-PDT may be an effective treatment for horses with IMMK. Further studies are needed to optimize this treatment modality.
© 2025 American College of Veterinary Ophthalmologists.
Get Full Text
Publication Date: 2025-05-05 PubMed ID: 40322843DOI: 10.1111/vop.70027Google 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.

This research explored the use of a treatment known as infracyanine green-based photodynamic therapy (InfraCG-PDT) on horses suffering from immune-mediated keratitis (IMMK). Based on careful study and follow-up of 47 horses, the treatment showed promising effectiveness, although further studies are needed for optimization.

Methodology

  • The research analyzed medical records from the Equine Clinic Munich-Riem and Auburn University Equine Ophthalmology Service spanning six years, from 2014 to 2020. The researchers homed in on horses diagnosed with IMMK that had been treated using InfraCG-PDT.
  • The treatment procedure involved administering multiple intrastromal injections of EmunDo (InfraCG) into the affected cornea quadrant and then irradiating it with diffuse diode laser energy. The amount of energy applied varied between 75J (for a quadrant) and 300J (for the entire cornea).

Results

  • The sample size comprised 51 eyes from 47 horses of 15 different breeds, aged between 4 and 29 years old. The breakdown included both individual cornea quadrants (54.9% of the eyes treated) and entire corneas (45.1% of the treatments).
  • Some complications arose in the immediate aftermath of the treatment: intrastromal fracture in 7.8% of the cases, intracameral InfraCG in 13.7%, and an epithelial blister in 1.9%. Furthermore, short-term complications such as prolonged dye retention (occurring in all the eyes treated) and superficial corneal ulceration (in 29.4% of the cases) were observed. Severe instances of globe-threatening ulcers (in 5.9% of the cases) were resolved without significant complications.
  • The outcome of the treatment was largely successful, with IMMK staying inactive or showing improvement in ocular lesions in 77.5% of the horses during the follow-up period. It is worth noting, however, that 10% of the horses needed additional treatment, and 12.5% were lost to follow-up.

Conclusion

  • The report concludes by underlining the potential effectiveness of InfraCG-PDT for treating IMMK in horses. Still, it also acknowledges the need for further studies aimed at optimizing this treatment modality.

Cite This Article

APA
Lam KP, Keys DA, McMullen RJ. (2025). Infracyanine Green-Based Photodynamic Therapy for Immune-Mediated Keratitis in Horses. Vet Ophthalmol. https://doi.org/10.1111/vop.70027

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English

Researcher Affiliations

Lam, Kimberly P
  • College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA.
Keys, Deborah A
  • Kaleidoscope Statistics LLC, Athens, Georgia, USA.
McMullen, Richard J
  • College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA.
  • Equine Clinic Munich-Riem, Munich, Germany.
  • Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

References

This article includes 30 references
  1. Matthews A, Gilger BC. Equine Immune‐Mediated Keratopathies. Veterinary Ophthalmology 12, no. S1 (2009): 10–16.
  2. Pate DO, Clode AB, Olivry T, Cullen JM, Salmon JH, Gilger BC. Immunohistochemical and Immunopathologic Characterization of Superficial Stromal Immune‐Mediated Keratitis in Horses. American Journal of Veterinary Research 73 (2012): 1067–1073.
  3. Gilger BC, Michau TM, Salmon JH. Immune‐Mediated Keratitis in Horses: 19 Cases (1998‐2004). Veterinary Ophthalmology 8 (2005): 233–239.
  4. Gilger BC, Stoppini R, Wilkie DA. Treatment of Immune‐Mediated Keratitis in Horses With Episcleral Silicone Matrix Cyclosporine Delivery Devices. Veterinary Ophthalmology 17, no. S1 (2014): 23–30.
  5. Davis AB, Schnabel LV, Gilger BC. Subconjunctival Bone Marrow‐Derived Mesenchymal Stem Cell Therapy as a Novel Treatment Alternative for Equine Immune‐Mediated Keratitis: A Case Series. Veterinary Ophthalmology 22 (2019): 674–682.
  6. Narinx F, Sauvage A, Ceusters J. Subconjunctival Autologous Muscle‐Derived Mesenchymal Stem Cell Therapy: A Novel, Minimally Invasive Approach for Treating Equine Immune‐Mediated Keratitis. Veterinary Ophthalmology 27 (2024): 424–433.
  7. Dieterman E, Hermans H, Slenter IJM. Outcome of Superficial Keratectomy Without Conjunctival Graft as a Surgical Technique for Immune‐Mediated Keratitis in Horses: Four Cases. Equine Veterinary Education 34, no. 8 (2022): e323–e330.
    doi: 10.1111/eve.13589google scholar: lookup
  8. Giuliano EA, Ota J, Tucker SA. Photodynamic Therapy: Basic Principles and Potential Uses for the Veterinary Ophthalmologist. Veterinary Ophthalmology 10 (2007): 337–343.
  9. Tamai K, Mizushima T, Wu X. Photodynamic Therapy Using Indocyanine Green Loaded on Super Carbonate Apatite as Minimally Invasive Cancer Treatment. Molecular Cancer Therapeutics 17 (2018): 1613–1622.
  10. Pinto A, Pocard M. Photodynamic Therapy and Photothermal Therapy for the Treatment of Peritoneal Metastasis: A Systematic Review. Pleura and Peritoneum 3 (2018): 20180124.
  11. Rossi F, Pini R, Menabuoni. Experimental Study on the Healing Process Following Laser Welding of the Cornea. Journal of Biomedical Optics 10 (2005): 024004.
  12. Matteini P, Sbrana F, Tiribilli B, Pini R. Atomic Force Microscopy and Transmission Electron Microscopy Analyses of Low‐Temperature Laser Welding of the Cornea. Lasers in Medical Science 24 (2009): 667–671.
  13. Sawa M, Awazu K, Takahashi T. Application of Femtosecond Ultrashort Pulse Laser to Photodynamic Therapy Mediated by Indocyanine Green. British Journal of Ophthalmology 88 (2004): 826–831.
  14. Ng ATJ, McMullen RJ Jr, Shaw GC. Limbal Squamous Cell Carcinoma in a Black Baldy Cow: Case Report and Surgical Treatment. Case Reports in Veterinary Medicine 2023 (2023): 2429241.
  15. Giuliano EA, MacDonald I, McCaw DL. Photodynamic Therapy for the Treatment of Periocular Squamous Cell Carcinoma in Horses: A Pilot Study. Veterinary Ophthalmology 11, no. S1 (2008): 27–34.
  16. Giuliano EA, Johnson PJ, Delgado C, Pearce JW, Moore CP. Local Photodynamic Therapy Delays Recurrence of Equine Periocular Squamous Cell Carcinoma Compared to Cryotherapy. Veterinary Ophthalmology 17, no. S1 (2014): 37–45.
  17. Lim H, Oh C. Indocyanine Green‐Based Photodynamic Therapy With 785 Nm Light Emitting Diode for Oral Squamous Cancer Cells. Photodiagnosis and Photodynamic Therapy 8 (2011): 337–342.
  18. Topaloglu N, Güney M, Yuksel S, Gülsoy M. Antibacterial Photodynamic Therapy With 808‐Nm Laser and Indocyanine Green on Abrasion Wound Models. Journal of Biomedical Optics 20, no. 2 (2015): 28003.
    doi: 10.1117/1.jbo.20.2.028003google scholar: lookup
  19. da Ruiz Moura Silva V, de Caldart Andra MC, Skilhan Faganello C. Evaluation of Equine Corneal Endothelium After Exposure to 0.5% Indocyanine Green—In Vitro Study. Semina: Ciências Agrárias 39 (2018): 613–620.
  20. Cillino S, Castellucci M, Cillino G. Infracyanine Green vs. Brilliant Blue G in Inverted Flap Surgery for Large Macular Holes: A Long‐Term Swept‐Source OCT Analysis. Medicina (Kaunas, Lithuania) 56 (2020): 43.
  21. Jackson TL, Vote B, Knight BC, el‐Amir A, Stanford MR, Marshall J. Safety Testing of Infracyanine Green Using Retinal Pigment Epithelium and Glial Cell Cultures. Investigative Ophthalmology & Visual Science 45 (2004): 3697–3703.
  22. Penha FM, Maia M, Farah ME. Morphologic and Clinical Effects of Subretinal Injection of Indocyanine Green and Infracyanine Green in Rabbits. Journal of Ocular Pharmacology and Therapeutics 24 (2008): 52–61.
  23. Rodriguez Galarza RM, McMullen RJ. Descemet's Membrane Detachments, Ruptures, and Separations in Ten Adult Horses: Clinical Signs, Diagnostics, Treatment Options and Preliminary Results. Veterinary Ophthalmology 23, no. 4 (2020): 611–623.
    doi: 10.1111/vop.12793google scholar: lookup
  24. De Potter P, Jamart J. Adjuvant Indocyanine Green in Transpupillary Thermotherapy for Choroidal Melanoma. Ophthalmology 110, no. 2 (2003): 406–414.
    doi: 10.1016/s0161‐6420(02)01560‐9google scholar: lookup
  25. Beil M. Advances in Photodynamic Therapy for the Treatment of Head and Neck Cancers. Lasers in Surgery and Medicine 38 (2006): 349–355.
  26. Sharp DM, Lai S, Markey CM. Photodynamic Therapy With Verteporfin for Choroidal Neovascularization due to Age‐Related Macular Degeneration and Other Causes: A New Zealand Outcomes Study. Clinical & Experimental Ophthalmology 35 (2007): 24–31.
  27. Tang G, Hyman S, Schneider JH Jr, Giannotta SL. Application of Photodynamic Therapy to the Treatment of Atherosclerotic Plaques. Neurosurgery 32, no. 3 (1993): 438–443.
    doi: 10.1227/00006123‐199303000‐00016google scholar: lookup
  28. Triesscheijn M, Baas P, Schellens JH. Photodynamic Therapy in Oncology. Oncologist 11 (2006): 1034–1044.
  29. Dougherty TJ, Gomer CJ, Henderson BW. Photodynamic Therapy. Journal of the National Cancer Institute 90 (1998): 889–905.
  30. Buchholz J, Walt H. Veterinary Photodynamic Therapy: A Review. Photodiagnosis and Photodynamic Therapy 10 (2013): 342–347.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 100,113 horse owners like you who receive our email updates on horse health and nutrition.