Evaluation of photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) in feline infectious keratitis-patient demographics, treatment protocols, risk factors, and treatment outcome: a retrospective study.

OBJECTIVES: To describe patient demographics and treatment protocols in a population of feline patients undergoing photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) as an adjunctive treatment for infectious keratitis. Furthermore, to determine the proportion of PACK-CXL treatment success in the population studied, explore risk factors for treatment failure, and provide recommendations for future PACK-CXL clinical studies. MATERIALS AND METHODS: Records from four veterinary ophthalmology practices were reviewed to identify eligible patients and extract data. Recorded variables included patient-related factors, ocular examination findings, PACK-CXL protocol parameters, and treatment outcome. RESULTS: Records for 153 cats (154 eyes) were included. Median age in the treatment success group was 8 years (interquartile range (IQR) 4-12), with a median ulcer depth of 30% (IQR 30-40). Median age in the treatment failure group was 10.5 years (IQR 4.75-12) with a median ulcer depth of 45.9% (IQR 30-75). Persian cats were the most represented brachycephalic breed (52 out of 64 cats). Modified PACK-CXL protocols were used, including fast energy delivery (134 eyes), and increased fluence (52 eyes). The overall proportion of success was 88% (95% CI 84-93), which was variable between clinics. Eighty-two of 89 mesocephalic cat eyes (92%), and 54 of 65 brachycephalic cat eyes (83%) were classified as treatment successes. CONCLUSIONS: PACK-CXL appeared to be a useful, adjunctive therapeutic modality for the treatment of infectious keratitis in the feline patient population presented here. Brachycephalic cats, older cats, and those with deeper ulcers may be at increased risk for treatment failure.

Effects of orally administered gabapentin, tramadol, and meloxicam on ocular variables in healthy dogs.

OBJECTIVE: To determine the effects of gabapentin, tramadol, and meloxicam on tear production, intraocular pressure (IOP), pupillary diameter, tear break-up time, and corneal touch threshold in healthy dogs when given orally for 3 days. ANIMALS: 9 healthy research Beagles. PROCEDURES: A randomized, blinded, case-crossover study with a 6-sequence, 3-treatment, and 3-period design was performed. A 7-day acclimation period was followed by 3 treatment phases, each with a 3-day treatment period followed by a 7-day washout period for 3 different drugs. Block randomization was used to group dogs for treatments with drug A (gabapentin), B (tramadol), or C (meloxicam). Measurements of tear production, IOP, pupillary diameter, tear break-up time, and corneal touch threshold were performed on a schedule. A generalized mixed-effects linear regression model was created for each ocular variable, accounting for repeated measures within individuals. RESULTS: Intraocular pressure was the only variable to have differed substantially between the first 5 and last 2 days of the acclimation period. When treatment phase, day, time of day, dog identification, baseline value, and eye were accounted for, the mean IOP was lower for dogs during treatment phases with gabapentin or tramadol, compared with meloxicam, but this difference was not considered clinically meaningful. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that a minimum 5-day acclimation period is necessary for IOP measurements to return to baseline in dogs. The statistically identified effect of gabapentin and tramadol on IOP in dogs of the present study warrants further investigation. It is possible that at higher dosages, or in dogs with glaucoma, this effect may become clinically significant.

Feline uveitis.

Uveitis is defined as inflammation of the vascular tunic of the eye, the uvea. Although inflammation can affect the entire uvea, clinical signs may present predominantly in either the anterior or the posterior chamber. Anterior uveitis lesions may affect the cornea, anterior chamber, iris, and lens, whereas posterior uveitis anomalies may be located in the vitreous and fundus. Uveal inflammation is often a sentinel finding indicative of underlying systemic pathology. Causes of feline uveitis are numerous, with infectious disease being the most common. Clinical signs are often nonspecific, and recurrence of disease is common, posing the challenges of accurate diagnosis and appropriate treatment.