Treatment of equine keratomycosis, part 1: selection of appropriate therapy based on clinical presentation and diagnostic testing improves clinical outcomes.

The research article presents a study focused on establishing the best treatment options for equine keratomycosis, a fungal infection in horses, by analyzing clinical outcomes, treatment costs, and hospitalization duration of past cases.

Research Methodology and Data Collection

• The research was retrospective, involving a review of past case records, conducted on 126 equine keratomycosis cases from over a period of 16 years (2004 to 2020).
• All cases had confirmed diagnoses of fungal infection obtained through cytology, culture, and/or histopathology. At least one month of follow-up was applied to all the cases.
• Thorough documentation of the ophthalmic examination, diagnostic test results, treatment details, and cost outcomes were achieved for all these cases.
• The outcomes were further classified based on the treatment type, and the relationship between the patient and diagnostic test variables on these outcomes were scrutinized using logistic and linear regression models.

Key Findings

• Positive clinical outcomes i.e., retention of the globe (eyeball) and restoration of vision were observed in a majority of the cases, both medically and surgically treated, with better percentages noticed for the latter.
• A minor increase in the positive clinical outcomes was noted with surgical treatment, though it lacked statistical significance. Specifically, in recent times, globe and vision preservation was successful in nearly 95% of cases post penetrating keratoplasty.
• The choice of surgery appeared to be influenced by the depth of the lesion. While medical treatment was related to relatively shorter hospital stays and lesser total and hospitalization costs when compared to all surgical treatments.
• Patients diagnosed with a stromal abscess had elevated total invoice and longer hospital stays as compared to those with ulcerative keratomycosis, despite similar clinical outcomes.

Conclusions

• Overall, the study finds that positive clinical outcomes were achievable for the majority of the keratomycosis cases, disregarding the disease severity. This finding underscores the importance of appropriate treatment selection that considers the specific clinical presentation of each case.
• By broadening knowledge and understanding of clinical decision-making, therapeutic alternatives, and associated clinical and financial outcomes, it is suggested that further improvements could be made in the treatment outcomes of equine keratomycosis.