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Home / Equine Research Bank / Vet Med Sci / Use of recombinant tissue plasminogen activator (rTPA) for t...
Veterinary medicine and science2024; 10(4); e1448; doi: 10.1002/vms3.1448

Use of recombinant tissue plasminogen activator (rTPA) for treatment of fibrin in the anterior chamber of the horse.

Abstract: Recombinant intracameral tissue plasminogen activator (rTPA) administration can aid clearance of fibrin from the anterior chamber. In this retrospective multicentre case series, the effect of intracameral rTPA administration to treat fibrin in the anterior chamber resulting from trauma or inflammatory ocular disease was evaluated. Clinical data from 30 treatments in 29 horses were obtained from medical records from 2003 to 2022. Association between time from onset of clinical signs and time for rTPA treatment to effect was studied with regression analysis. Twenty-seven horses (93.1%) had no previous history of ophthalmic disease; one had an iridic cyst, and another had equine recurrent uveitis. The majority of cases were related to trauma (79.3%). Median time from the onset of clinical signs to treatment was 12 h (IQR = 4-48 h). rTPA (72% 20 µg; 24% 25 µg; 3.3% 40 µg) was administered once in all but one eye, which was treated twice. Resolution of fibrin was seen in 96.9% (29/30) of treatments. Fibrin accumulation recurred in one case but resolved 14 days after the second treatment. Complications were seen in four treatments (13.3%): moderate pain for 24 h, intracameral debris and mild intracameral haemorrhage in a horse that received 40 µg of tissue plasminogen activator. Recurrence of fibrin accumulation was absent in 96.7% of cases. Median time to effect was 20 min (IQR = 10-45 min). Time for rTPA treatment to effect was not associated with time from fibrin formation (R2 = 0.09; p = 0.11). Intracameral rTPA treatment can be considered at 20-25 µg in 0.1 mL solution to aid resolution of fibrin accumulation.
© 2024 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.
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Publication Date: 2024-05-31 PubMed ID: 38818763PubMed Central: PMC11140448DOI: 10.1002/vms3.1448Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study
  • Research Support
  • Non-U.S. Gov't

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.

The research article investigates the use of recombinant tissue plasminogen activator (rTPA) in treating fibrin presence in the anterior chamber of the horse’s eye, which is often caused by trauma or inflammation-related ocular diseases.

Objective and Methodology

  • This study was built as a retrospective multicentre case series to assess the efficiency of intracameral rTPA in resolving fibrin accumulation in the horse’s eye.
  • The researchers collected clinical data spanning from 2003 to 2022 from medical records of 29 horses subjected to 30 treatments.
  • A regression analysis was used to study the association between the time from the onset of clinical signs and the time it took for the rTPA treatment to take effect.

Findings

  • The majority of the horses in the study (93.1%) had no past record of ophthalmic disease, barring one horse each that had an iridic cyst and equine recurrent uveitis.
  • Links to trauma were found in the majority of the cases (79.3%).
  • The median time from the onset of clinical signs associated with fibrin accumulation to administration of rTPA treatment was 12 hours.
  • All horses, except for one, received the rTPA treatment once. The dosage varied between 20 µg to 40 µg, with the majority receiving 20 µg (72%).
  • Fibrin resolution was observed in 96.9% of the treatments. One case witnessed a recurrence of fibrin accumulation, which was later resolved 14 days after the second treatment.
  • Several complications were noted in four treatments, including moderate pain for 24 hours, intracameral debris, and mild intracameral haemorrhage in one horse that had been administered 40 µg of rTPA.
  • The study found no recurrence of fibrin accumulation in 96.7% of the cases. The median time to see the effects of the treatment was approximately 20 minutes.
  • No association was found between time for rTPA treatment to take effect and time from fibrin formation (R = 0.09; p = 0.11).

Conclusions

  • The study concludes intracameral rTPA treatment can be efficacious in aiding the resolution of fibrin accumulation in the anterior chamber of the horse’s eye.
  • The dosage recommended for effective treatment would be around 20-25 µg in a 0.1 mL solution.

Cite This Article

APA
Pereira R, Bowen M, Rapezzano G, Redpath A, Pratt S, Hallowell G. (2024). Use of recombinant tissue plasminogen activator (rTPA) for treatment of fibrin in the anterior chamber of the horse. Vet Med Sci, 10(4), e1448. https://doi.org/10.1002/vms3.1448

Publication

Veterinary medicine and science
ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 10
Issue: 4
Pages: e1448

Researcher Affiliations

Pereira, Regina
  • Pool House Equine Hospital, IVC Evidensia, Malton, UK.
Bowen, Mark
  • Medicine Vet Equine Referrals Limited, Nottingham, UK.
Rapezzano, Giulia
  • Pool House Equine Hospital, IVC Evidensia, Malton, UK.
Redpath, Adam
  • Donnington Grove Equine Hospital, IVC Evidensia, Malton, UK.
Pratt, Steffi
  • Oakham Veterinary Hospital, School of Veterinary Medicine, IVC Evidensia, University of Nottingham, Nottingham, UK.
Hallowell, Gayle
  • Pool House Equine Hospital, IVC Evidensia, Malton, UK.

MeSH Terms

  • Animals
  • Horses
  • Tissue Plasminogen Activator / administration & dosage
  • Horse Diseases / drug therapy
  • Retrospective Studies
  • Fibrin
  • Female
  • Male
  • Anterior Chamber / drug effects
  • Fibrinolytic Agents / pharmacology
  • Fibrinolytic Agents / administration & dosage
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use
  • Eye Diseases / veterinary
  • Eye Diseases / drug therapy

Grant Funding

  • IVC Evidensia

Conflict of Interest Statement

Some of the co‐authors are reviewers for this journal. One of the co‐authors is the editor of this journal.

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