Long-term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis.
Abstract: To determine the long-term efficacy, complications, and duration of effect of a cyclosporine (CsA) suprachoroidal implant (CSI) in horses with equine recurrent uveitis (ERU). Methods: Horses with ERU were treated with a 6-mm diameter, 25 mg, reservoir matrix CsA implant in the deep sclera adjacent to the suprachoroidal space. Horses with follow-up >1 year were examined for frequency of uveitis episodes, complications, and vision at last recheck. Results: Data from 151 eyes of 133 horses from the USA and Europe that had CsA devices implanted for ERU were reviewed. Follow-up time ranged from 13 to 85 months after surgery, with a mean and median follow-up time of 28.9 and 26.3 months, respectively. Overall, at last follow-up 78.8% of eyes were considered visual and the overall mean frequency of uveitis episodes after CSI was 0.09 ± SD 0.08 episodes per month. The most common complications leading to vision loss at last follow-up were persistent uveitis episodes (54%), glaucoma (22%), mature cataracts (16%), and retinal detachment (6%). Persistent uveitis episodes tended to be the highest cause of vision loss in horses with <24 months and >48 months of follow-up. Conclusions: This study demonstrated the long-term maintenance of vision of horses with ERU implanted with a CSI. The increased vision loss related to uveitis episode of inflammation in eyes after the likely depletion of CsA from the CSI suggests that a repeat CSI may be required at or before 48 months after surgery.
Publication Date: 2010-09-16 PubMed ID: 20840106DOI: 10.1111/j.1463-5224.2010.00807.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research article studies the long-term effect, complications, and impact of a cyclosporine implant in horses suffering from equine recurrent uveitis. The study concludes that these implants help maintain vision in horses over the long term, however, a repeat implant may be required after roughly 4 years, as the implant’s medicine is likely depleted leading to a return of inflammation episodes.
Objective of the Research
- The study aims to determine the long-term efficiency, complications, and the duration of the effects of the cyclosporine suprachoroidal implant (CSI) in horses suffering from equine recurrent uveitis (ERU).
- The study uses a 25mg reservoir matrix cyclosporine implant, with 6mm diameter, placed in the deep sclera adjacent to the suprachoroidal space to treat horses.
Participants and Methodology
- The data from 151 eyes of 133 horses from the USA and Europe were analyzed. These horses had cyclosporine devices implanted to treat ERU.
- The follow-up time for these horses ranged from 13 to 85 months after the surgery, with an average and median follow-up time of 28.9 and 26.3 months respectively.
Results of the Study
- About 78.8% of eyes were considered visual at the last follow-up. After the cyclosporine suprachoroidal implant, the average frequency of uveitis episodes was approximately 0.09 ± SD 0.08 episodes per month.
- Complications that led to vision loss include persistent uveitis episodes (54%), glaucoma (22%), mature cataracts (16%), and retinal detachment (6%).
- Persistent uveitis episodes were observed to be the leading cause of vision loss in horses with less than 24 months and more than 48 months of follow-up.
Conclusions
- The study demonstrates that using the CSI helps to maintain the vision of horses suffering from ERU over the long term.
- However, the study also suggests that a repeat CSI could be required at or before 48 months after surgery, as the depletion of cyclosporine from the implant could potentially result in increased inflammation episodes.
Cite This Article
APA
Gilger BC, Wilkie DA, Clode AB, McMullen RJ, Utter ME, Komaromy AM, Brooks DE, Salmon JH.
(2010).
Long-term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis.
Vet Ophthalmol, 13(5), 294-300.
https://doi.org/10.1111/j.1463-5224.2010.00807.x Publication
Researcher Affiliations
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA. bgilger@ncsu.edu
MeSH Terms
- Animals
- Cyclosporine / administration & dosage
- Cyclosporine / therapeutic use
- Female
- Horse Diseases / drug therapy
- Horses
- Immunosuppressive Agents / administration & dosage
- Immunosuppressive Agents / therapeutic use
- Infusion Pumps, Implantable / veterinary
- Male
- Uveitis / drug therapy
- Uveitis / veterinary
Citations
This article has been cited 16 times.- Gerras J, Young K, Roberts D, Waldman G, Salmon JH, Gilger BC. Uveitis and blindness in a closed herd of Equidae following leptospiral infection. Front Vet Sci 2024;11:1504990.
- Morén S, Kallberg M, Strom L. Equine uveitis: Outcome and adverse effects after one or two intravitreal low-dose gentamicin injections. Equine Vet J 2025 Jan;57(1):160-168.
- Geiger T, Gerhards H, Bjelica B, Mackenthun E, Wollanke B. Analysis of 1840 Equine Intraocular Fluid Samples for the Presence of Anti-Leptospira Antibodies and Leptospiral DNA and the Correlation to Ophthalmologic Findings in Terms of Equine Recurrent Uveitis (ERU)-A Retrospective Study. Vet Sci 2022 Aug 21;9(8).
- Abrol V, Kushwaha M, Mallubhotla S, Jaglan S. Chemical mutagenesis and high throughput media optimization in Tolypocladium inflatum MTCC-3538 leads to enhanced production of cyclosporine A. 3 Biotech 2022 Aug;12(8):158.
- 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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- Gaballa SA, Kompella UB, Elgarhy O, Alqahtani AM, Pierscionek B, Alany RG, Abdelkader H. Corticosteroids in ophthalmology: drug delivery innovations, pharmacology, clinical applications, and future perspectives. Drug Deliv Transl Res 2021 Jun;11(3):866-893.
- Komáromy AM, Bras D, Esson DW, Fellman RL, Grozdanic SD, Kagemann L, Miller PE, Moroi SE, Plummer CE, Sapienza JS, Storey ES, Teixeira LB, Toris CB, Webb TR. The future of canine glaucoma therapy. Vet Ophthalmol 2019 Sep;22(5):726-740.
- Fischer BM, McMullen RJ Jr, Reese S, Brehm W. Intravitreal injection of low-dose gentamicin for the treatment of recurrent or persistent uveitis in horses: Preliminary results. BMC Vet Res 2019 Jan 16;15(1):29.
- Chiang B, Jung JH, Prausnitz MR. The suprachoroidal space as a route of administration to the posterior segment of the eye. Adv Drug Deliv Rev 2018 Feb 15;126:58-66.
- Sandmeyer LS, Bauer BS, Feng CX, Grahn BH. Equine recurrent uveitis in western Canadian prairie provinces: A retrospective study (2002-2015). Can Vet J 2017 Jul;58(7):717-722.
- Chiang B, Venugopal N, Grossniklaus HE, Jung JH, Edelhauser HF, Prausnitz MR. Thickness and Closure Kinetics of the Suprachoroidal Space Following Microneedle Injection of Liquid Formulations. Invest Ophthalmol Vis Sci 2017 Jan 1;58(1):555-564.
- Wang J, Jiang A, Joshi M, Christoforidis J. Drug delivery implants in the treatment of vitreous inflammation. Mediators Inflamm 2013;2013:780634.
- Lin P, Suhler EB, Rosenbaum JT. The future of uveitis treatment. Ophthalmology 2014 Jan;121(1):365-376.
- Kompella UB, Amrite AC, Pacha Ravi R, Durazo SA. Nanomedicines for back of the eye drug delivery, gene delivery, and imaging. Prog Retin Eye Res 2013 Sep;36:172-98.
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