Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices.
Abstract: To describe the use of episcleral silicone matrix cyclosporine (ESMC) drug delivery devices in horses with immune-mediated keratitis (IMMK) with evaluation of tolerability and efficacy in long-term control of inflammation. Methods: Retrospective study. ESMC implants (1.2 cm length, 30% wt/wt cyclosporine (CsA) in silicone; with approximately 2 μg/day steady-state release for at least 400 days) were used. Results: Nineteen horses (20 eyes) received two or more ESMC implants for superficial stromal (n = 9), midstromal (n = 3), or endothelial (n = 5) IMMK. Three additional horses received two or more ESMC implants for pigmentary keratouveitis (PK). Nine eyes of eight horses with superficial and five eyes of five horses with endothelial IMMK were well controlled after placement of ESMC implants (mean follow-up 176.8 and 207.2 days, respectively). Horses with midstromal IMMK and PK were not controlled with ESMC implants alone, but instead required frequent use of other medications or surgery to control the disease. The mean duration of disease prior to ESMC implantation of horses with midstromal IMMK was 495 ± 203.9 days, compared with 121.6 ± 92.7 days with superficial IMMK. ESMC implants were well tolerated by all horses without documented loss of the device. Conclusions: Results from this preliminary retrospective study suggest that the ESMC implants were well tolerated and associated with treatment success with superficial and endothelial IMMK, especially if placed early in the disease process. Further study is needed to determine the duration of efficacy, number of implants required, and better therapies for chronic midstromal IMMK and pigmentary keratouveitis.
© 2013 American College of Veterinary Ophthalmologists.
Publication Date: 2013-08-01 PubMed ID: 23910236DOI: 10.1111/vop.12087Google Scholar: Lookup
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- Journal Article
Summary
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This research looked into the use of episcleral silicone matrix cyclosporine (ESMC) devices in the treatment of horses with immune-mediated keratitis (IMMK) and evaluated their effectiveness and tolerance over an extended period. The study found that the ESMC devices were well-tolerated and successful in treating superficial and endothelial IMMK when applied early in the disease progression.
Objective of the Study
- The main goal of the study was to investigate and describe the usage, efficacy, and tolerability of episcleral silicone matrix cyclosporine (ESMC) devices in treating horses with immune-mediated keratitis (IMMK).
Methods Used
- The approach used in this study was retrospective in nature.
- ESMC implants (1.2 cm, 30% weight/weight cyclosporine in silicone, releasing approximately 2 μg/day for at least 400 days) were employed for the research.
Results of the Study
- Twenty eyes from nineteen horses received two or more ESMC implants for treating different types of IMMK. Meanwhile, three more horses received two or more ESMC implants to treat pigmentary keratouveitis (PK).
- Superficial and endothelial IMMK in several horses were well managed after the placement of ESMC implants, showing its potential efficacy in these cases.
- However, ESMC implants weren’t effective alone for midstromal IMMK and PK. These conditions required additional medications or surgery.
- The duration of the disease prior to ESMC implantation was significantly longer in horses suffering from midstromal IMMK in comparison to superficial IMMK.
- All horses well tolerated the ESMC implants without any documented loss of the device.
Conclusion of the Study
- The study indicates that ESMC implants could be a successful and well-tolerated treatment for superficial and endothelial IMMK, especially if used earlier in the disease process.
- However, the study also acknowledges that further research is needed to understand better therapeutic solutions for chronic midstromal IMMK and pigmentary keratouveitis, determine the number of implants required and ascertain the duration of efficacy.
Cite This Article
APA
Gilger BC, Stoppini R, Wilkie DA, Clode AB, Pinto NH, Hempstead J, Gerding J, Salmon JH.
(2013).
Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices.
Vet Ophthalmol, 17 Suppl 1, 23-30.
https://doi.org/10.1111/vop.12087 Publication
Researcher Affiliations
- Department of Clinical Sciences, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
MeSH Terms
- Animals
- Cyclosporine / administration & dosage
- Cyclosporine / therapeutic use
- Drug Implants / administration & dosage
- Female
- Horse Diseases / drug therapy
- Horses
- Immunosuppressive Agents / administration & dosage
- Immunosuppressive Agents / therapeutic use
- Keratitis / drug therapy
- Keratitis / veterinary
- Male
- Sclera
- Silicones
- Treatment Outcome
Citations
This article has been cited 6 times.- Padjasek M, Cisło-Sankowska A, Lis-Bartos A, Qasem B, Marycz K. PLDLA/TPU Matrix Enriched with Cyclosporine A as a Therapeutic Platform for Immune-Mediated Keratitis (IMMK) in Horses. Int J Mol Sci 2023 Mar 17;24(6).
- Padjasek M, Qasem B, Cisło-Pakuluk A, Marycz K. Cyclosporine A Delivery Platform for Veterinary Ophthalmology-A New Concept for Advanced Ophthalmology. Biomolecules 2022 Oct 20;12(10).
- 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.
- Young KAS, Schnabel LV, Gilger BC. Cell and Gene Therapy in Equine Ocular Disease. Vet Ophthalmol 2026 Mar;29(2):e70151.
- Tucker-Retter EK, Yamagata M, Gilger B, Oh A. Retrospective Assessment of Carbonic Anhydrase Inhibitors in Topical or Episcleral Implant Form for the Treatment of Equine Glaucoma. Vet Ophthalmol 2025 Nov;28(6):977-982.
- Preston JF, Mustikka MP, Priestnall SL, Dunkel B, Fischer MC. Clinical features and outcomes of horses presenting with presumed equine immune mediated keratitis to two veterinary hospitals in the United Kingdom and Finland: 94 cases (2009-2021). Equine Vet J 2025 May;57(3):598-610.
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