Equine ulcerative keratitis with furrow: A review of the outcomes of 72 cases from 1987 to 2015.

BACKGROUND: Ulcerative keratitis with peripheral furrow formation is a poorly-described condition which has been associated with a grave prognosis due to rapid necrosis of the cornea. OBJECTIVE: To describe the infectious aetiologies associated with furrow-forming ulcerative keratitis, its overall clinical course and the efficacy of medical and surgical intervention in horses. STUDY DESIGN: Retrospective clinical case series. METHODS: Medical records of 72 horses which presented with furrow-forming ulcerative keratitis at the University of Florida between 1987 and 2015 were reviewed. RESULTS: Seventy-two horses (72 eyes) with furrow-forming ulcerative keratitis were treated at the University of Florida between 1987 and 2015. Of these, a definitive aetiologic diagnosis was available for 37 eyes. Ten of 37 eyes (27%) were diagnosed with fungal keratitis based on cytology of corneal scraping, culture, histopathology and/or fungal PCR. Fourteen of 37 eyes (38%) were diagnosed with a mixed fungal and bacterial keratitis. Thirteen of 37 eyes (35%) were diagnosed with bacterial keratitis. Overall, 26 of 72 total eyes were treated with medical therapy alone (36%). Forty-six of 72 eyes were treated medically and surgically (64%). Of the 26 eyes which received medical therapy, 20 healed with a positive visual outcome (77%) and 6 eyes were non-visual (23%). Of the 46 eyes which received surgical intervention, 40 healed with a positive visual outcome (87%), while six eyes were non-visual (13%). Altogether, 60 of 72 eyes healed with a positive visual outcome following medical or surgical treatment of furrow-forming ulcerative keratitis (83%). Twelve of 72 eyes failed treatment (17%), with six eyes requiring enucleation and six globes becoming phthisical after treatment. MAIN LIMITATIONS: Inconsistencies in available medical record data due to the large span of time (1987-2015) are inherent in this retrospective study, along with gradual evolution of corneal surgical techniques and medical therapies over the decades. CONCLUSIONS: Furrow-forming ulcerative keratitis was associated with a positive visual outcome in 83% of horses treated at the University of Florida between the years 1987 and 2015. Furrow formation may be associated with either fungal or bacterial infection.

Evaluation of three hand-held tonometers in normal canine eyes.

Tonometry, an indirect measurement of intraocular pressure (IOP), is important for the diagnosis and management of glaucoma and uveitis. The aim of this study was to compare the performance of three hand-held tonometers in normal canine eyes. Eyes from cadavers of dogs without observable ocular disease were used to compare tonometric measurements with direct manometry over a range of 7.4-65mmHg. In vivo measurements using the three tonometers in both eyes of 12 healthy dogs were compared. All tonometers significantly underestimated manometric values both ex vivo and in vivo. One tonometer showed a small fixed bias over the range of IOP, whilst the other two tonometers had a negative proportional bias. The results of this study show that differences exist between handheld tonometers across the clinically relevant range of IOP, and that all underestimate manometric measurements.

Evaluating approaches to measuring ocular pain in bovine calves with corneal scarification and infectious bovine keratoconjunctivitis-associated corneal ulcerations.

Infectious bovine keratoconjunctivitis (IBK) is a common ocular disease in cattle, associated with a 6.8 to 13.6 kg decrease in weaning weight. Antibiotic therapy is available but it is unclear if pain mitigation as an adjunct therapy would reduce the weight loss associated with IBK. Before assessing the impact of pain mitigation therapies, it is first necessary to validate approaches to qualifying ocular pain. The objective of this study was to evaluate approaches to qualifying ocular pain in bovine calves (Bos taurus) with IBK. Our a priori assumption was that scarification or corneal ulcerations consistent with IBK are painful compared to normal eyes. To quantify this difference in pain, we assessed 4 tools: pressure algometry-mechanical nociceptive threshold (PA-MNT), corneal touch thresholds (CTT) obtained with the use of a Cochet-Bonnet aesthesiometer, and assessment for the presence of blepharospasm and photophobia as metrics for pain. Using a 1-eye randomized controlled challenge trial, 31 calves with healthy eyes were randomly allocated to treatment groups, and then a left or right eye was randomly assigned for corneal scarification and inoculation with Moraxella bovoculi or Moraxella bovis. A repeated measures analysis of variance was used for PA-MNT, with significance set at P < 0.05. A log (base 10) transformation was used to stabilize the variance, and Tukey's t tests were used to test differences between assessment days for each landmark. Calves had statistically significantly lower PA-MNT scores (which indicates more pain) the day after scarification relative to baseline measurements (4 d before scarification). For example, at 1 landmark the median PA-MNT (kg/force) prescarification was 4.82 (95% confidence interval [CI]: 3.92-5.93) and 3.43 (95% CI: 2.79-4.22) postscarification. These data suggest PA-MNT may be a tool for quantifying ocular pain in calves. No differences (P < 0.1) in PA-MNT scores between scarified and not-scarified eyes were detected for any landmark on any day. This result suggests that the pain response occurs over the entire face, not just the affected eye. Corneal ulcerations consistent with IBK were not associated with statistically significant differences in PA-MNT or CTT at eye or calf levels. Not surprisingly, scarified eyes were more likely to exhibit blepharospasm and photophobia compared to healthy eyes. Due to blepharospasm, the use of the Cochet-Bonnet to evaluate corneal sensitivity by CTT was of limited value.

Randomized blinded challenge study to assess association between Moraxella bovoculi and Infectious Bovine Keratoconjunctivitis in dairy calves.

The objective of this study was to evaluate if Moraxella bovoculi was associated with Infectious Bovine Keratoconjunctivitis (IBK) using a corneal scarification model in calves. A 3-arm single-eye block-randomized and blinded challenge study was designed as follows: corneal scarification only, corneal scarification and inoculation with M. bovoculi (ATCC strain: BAA-1259; origin: CA) and corneal scarification and inoculation with Moraxella bovis (strain Epp63-300; origin: NADC). The study was conducted in 3 replicates of 10-12 animals housed in individual pens with no nose-to-nose contact. Calves were enrolled after an ophthalmologist confirmed the absence of corneal, conjunctival, and eyelid abnormalities. Calves were scarified and inoculated in one randomly selected eye, then observed for the primary outcome of interest (corneal ulcers) until euthanized 10 days following scarification. Research group members assessing the outcome were blind to allocation status. The study was approved by the institutional animal care and use committee. Of 36 animals purchased for the study, 5 were excluded prior to enrollment due to ophthalmic abnormalities. Of the 31 enrolled calves, 9/10 (90%) of M. bovis calves, 0/10 (0%) of M. bovoculi calves and 1/11 (9%) of control calves developed corneal ulcerations consistent with IBK in the scarified eyes. The absence of corneal ulcerations in M. bovoculi BAA-1259 inoculated calves suggests it is not a causal organism for IBK in this model and the pathogenicity of this ATCC strain has not been established. Consistent corneal ulceration development in the M. bovis inoculated group demonstrates the ability of the model to induce IBK ulcers.

Ocular metastasis of a vaccine-associated fibrosarcoma in a cat.

A 6-year-old, neutered male domestic shorthair cat was evaluated for a recurrent vaccine-associated fibrosarcoma. The cat had three excisions of the tumour prior to presentation and was referred for radiation therapy. Ten months following treatment with radiation therapy, the cat was presented again for a cloudy appearance to the eye. An exenteration was performed, and biopsy revealed fibrosarcoma. At the same time, two discrete pulmonary nodules were identified on thoracic radiographs. Two doses of doxorubicin (20 mg/m(2)) and cyclophosphamide (100 mg/m(2)) were administered intravenously 3 weeks apart. Despite treatment, the pulmonary nodule doubled in size. This case represents the first antemortem report of ocular metastasis of a vaccine-associated sarcoma and supports the highly aggressive nature of these tumours.

Canine and feline primary ocular bacterial infections.

Bacterial infections are frequently associated with diseases of the eyelids, cornea, and conjunctiva. Animals sustaining KCS commonly have bacterial infections of the external eye owing to a lack of antimicrobial properties present in the normal tearfilm. Infection can occur in the nasolacrimal duct or lacrimal sac, which is referred to as dacryocystitis. Severe corneal ulcers are frequently infected with bacteria, especially Pseudomonas sp. Three new topical ophthalmic antibiotics have recently become commercially available: ciprofloxacin, norfloxacin, and ofloxacin.

Exophthalmos secondary to aspergillosis in a cat.

Clinical signs of orbital disease include exophthalmos, strabismus, or, less commonly, enophthalmos. Fungal orbital disease is uncommon. A case of nasal, frontal sinus, and orbital aspergillosis in a cat is described. Diagnostics for exophthalmos and therapy for retrobulbar abscesses are discussed.

The influence of aging and low zinc nutrition on the choroid in the pig: I. The melanocyte.

The effects of low zinc nutrition and aging on central choroidal melanocytes were examined in the pig. Three populations of pigs (young, pregnant and aged), were maintained on either control (C) or low zinc (LZ) diets. Twenty-five weanling boars were sacrificed at 2, 4, 8, 10, and 12-month intervals, and nine pregnant sows and eight aged sows were sacrificed after a 6-month interval. Melanocytes of the central choroid were morphologically and morphometrically examined. The melanocyte was found to be conservative in its form, which was mostly elliptical longitudinal profile, throughout the different age populations that were fed the C diet. Morphometric observations revealed that this cell type increased in size in the oldest animals, having been 40% greater than that in the younger two populations. However, the overall percentage area occupied by melanocytes remained the same throughout all age groups. In the animals that were fed the LZ diets, a large subpopulation of choroidal melanocytes was oval to round in shape in the pregnant and aged groups. Many members of this subpopulation possessed less opaque pigment than the elliptically shaped cell. Measurements of the size and percentage area occupied in these oldest groups increased significantly. In addition to the change of size, shape and melanin opaqueness, unusually large melanosomes were consistently observed in the pregnant and aged LZ groups. Low zinc nutrition had a remarkable age-related impact on the usually quiescent melanocyte.

The influence of aging and low zinc nutrition on the choroid in the pig: II. The melanosome.

The effects of low zinc nutrition and aging on central choroidal melanosomes were examined in the pig. Melanosomes of central choroidal melanocytes were morphologically and morphometrically examined in three populations of pigs (young, pregnant and aged), that were maintained on either control (C) or low zinc (LZ) diets. In C groups, the typical melanosomes decreased in size with age, although a subpopulation of larger melanosomes occurred in the oldest group. In contrast, the melanosomes of the animals on LZ diets increased in size significantly in the adult groups. The melanosomes in the pregnant and aged groups were 65% and 30-40% greater than those of the age-matched C groups. Extremely large melanosomes were frequently encountered in adult LZ choroidal melanocytes. Melanogenesis of these large bodies included the formation of one or more outer shells. Fusion of adjacent large melanosomes was also observed. Melanolysosomal-like bodies were observed, particularly among the pigmented cells in the large blood vessel region of C and LZ adults. Melanin dynamics, i.e. its production and breakdown, occurred within choroidal melanocytes throughout much of the lifespan of the pig. This dynamic was greatly influenced by low zinc nutrition, resulting in unusual and aberrant melanin activity.

Surgical reconstruction of severe cicatricial ectropion in a puppy.

A three-month-old chow chow mixed-breed puppy was presented with severe cicatricial ectropion of the upper eyelids after being burned maliciously. The burn wounds healed by second intention with contracture, causing eversion, elevation, and immobilization of the upper eyelids. The puppy was unable to blink or close the upper eyelids due to cicatrix (i.e., scar) formation. Surgical repair using tissue-relaxing procedures was successful in reducing corneal exposure and improving the puppy's appearance.

Intraocular silicone prosthesis implantation in eyes of dogs and a cat with intraocular neoplasia: nine cases (1983-1994).

OBJECTIVE: To determine the outcome of implantation of an intraocular silicone prosthesis (ISP) in the eyes of dogs and cats with intraocular neoplasia. DESIGN: Retrospective case series. ANIMALS: Eight dogs and 1 cat with histologically confirmed intraocular neoplasia. PROCEDURE: Signalment, clinical signs before and after surgery, results of microscopic examination of eviscerated intraocular tissues, follow-up information, and necropsy findings, if available, were recorded for each animal. RESULTS: Five dogs and 1 cat had primary intraocular neoplasms. Two of the dogs developed regrowth of the neoplasm around the ISP 6 to 24 months after implantation, and the eyes were enucleated. The cat developed signs compatible with systemic metastasis 4 years after surgery and was euthanatized. Three dogs had multicentric or metastatic neoplasia involving the eye. Two of these dogs were euthanatized because of their systemic disease 1.5 to 7 months after ISP implantation. The third dog is alive without evidence of regrowth 3 years after surgery. CLINICAL IMPLICATION: Intraocular neoplasia is not an absolute contraindication to ISP implantation.

Traumatic ocular proptoses in dogs and cats: 84 cases (1980-1993).

Eighteen eyes of 66 dogs were visual on reevaluation of traumatic proptosis. Twenty-one eyes were enucleated, and 4 dogs were euthanatized. In 18 cats, no eyes regained vision after traumatic proptosis: 12 cats had the affected eye enucleated, 2 had an eye that was considered blind, and 4 cats were euthanatized. Affected eyes of 45 dogs and 2 cats underwent surgical replacement and temporary tarsorrhaphy. Favorable prognostic indicators for eyes undergoing surgical replacement included proptosis in a brachycephalic dog, positive direct or consensual pupillary light response, normal findings on posterior segment examination, and a proptosed eye that had vision on initial examination. Unfavorable prognostic indicators included proptosis in a nonbrachycephalic dog, proptosis in cats, hyphema, no visible pupil, facial fractures, optic nerve damage, and avulsion of 3 or more extraocular muscles.

Characterization of naturally occurring cutaneous neurofibromatosis in Holstein cattle. A disorder resembling neurofibromatosis type 1 in humans.

Neurofibromatosis in cattle is typically a noncutaneous disease. A small group of cows in a Holstein dairy herd developed cutaneous neurofibromatosis. This unique condition was investigated and compared with neurofibromatosis type 1 (NF1) in humans. All cutaneous lesions but one were consistent with neurofibromas in noncutaneous sites in cattle and neurofibromas in patients with NF1. One bovine lesion was classified as a neurofibrosarcoma. Immunohistochemistry and electron microscopy supported Schwannian differentiation in benign and malignant lesions. Linkage analysis with a polymorphism in the bovine NF1 gene confirmed that two affected animals from the same sire inherited the same paternal NF1 allele. Bovine cutaneous neurofibromatosis is a naturally occurring disease in this group of animals, characterized by skin tumors morphologically identical to those of NF1. An informative polymorphism at the NF1 locus of two animals and their sire suggests this disorder may be caused by hereditary mutations at the bovine NF1 locus.

Histological findings in corneal stromal abscesses of 11 horses: correlation with cultures and cytology.

Histopathology was compared to culture results and cytology from horses with corneal stromal abscess at the Auburn University and the Ohio State University Veterinary Teaching Hospitals. Significant bacteria were not isolated in culture or seen on histopathology in any of the horses. Although most bacteria infecting equine corneas can be isolated with blood and MacConkey's agars, failure to detect bacterial growth may not rule out infection because anaerobic or intracellular bacteria would not be isolated. The inability to visualise bacterial organisms on histological sections did not rule out their presence in the tissue, because there is often destruction of bacteria by neutrophils, macrophages and antibiotic therapy greatly reducing their numbers. Fungal keratitis was diagnosed by histopathology in 4 of 11 eyes (36%) and keratitis with no aetiological agent in 7 of 11 eyes (64%). Nine of 11 horses (82%) had a prominent neutrophilic stromal infiltrate and 2 (18%) had a predominantly pyogranulomatous reaction. Two of the 4 lesions that showed histological evidence of fungal infection were positive for identifiable fungi on culture and cytology. Fungal cultures of the other 2 cases with histological evidence of mycotic keratitis were negative or grew unidentifiable fungi which were considered pathogenic because, on histopathological sections, fungal hyphae were found deep in the corneal stroma surrounded by an inflammatory reaction. In 3 of 6 cases where fungi were recovered on culture, they were considered contaminants based on lack of evidence of organisms in histopathological sections. Histopathology and the use of special stains were important in the interpretation of culture and cytology results.

Concomitant brainstem axonal dystrophy and necrotizing myopathy in vitamin E-deficient rats.

The purpose of this study was to simultaneously evaluate in rats the effects of vitamin E depletion on tissue alpha-tocopherol (alpha-T) concentrations, electrophysiologic measurements and histopathology. Rats (21-day-old male Wistar) were fed either vitamin E-deficient or supplemented (control) diets (n = 6/group) for 10, 16, and 61 weeks. At these times, electrophysiologic tests (electromyography, spinal and somatosensory evoked potentials, and motor nerve conduction velocity) were performed, the rats were killed and alpha-T concentrations of adipose tissue, sciatic nerve, and cervical and lumbar spinal cord were measured along with histopathologic evaluation of skeletal muscles and the nervous system. By 61 weeks, depletion of alpha-T from adipose tissue and peripheral nerve was more severe (< 1% of controls) than from cervical and lumbar spinal cord (15 and 8% of controls, respectively). Electrophysiologic tests were normal at all times. Histopathologic evaluation at 61 weeks revealed normal peripheral nerve structure, but necrosis of type 1 muscle fibers and increased numbers of spheroids in the gracile and cuneate nuclei. Our results confirm that low alpha-T concentrations in tissues precede histologic changes in peripheral nerves and skeletal muscle. Furthermore, pathologic changes associated with vitamin E deficiency occur independently in muscle and nervous tissue of rats.

Modified lateral orbitotomy for removal of orbital neoplasms in two dogs.

A simplified lateral orbitotomy is described that decreases surgical time and lessens tissue dissection, yet maintains the exposure to the orbit provided by other orbitotomy techniques. The approach involves cutting the orbital ligament, incising the temporalis aponeurosis from the dorsal zygomatic arch, making parallel zygomatic arch osteotomies, and reflecting the zygomatic arch ventrally. Closure of the wound involves wiring the zygomatic arch back into place. This orbitotomy procedure provides excellent exposure for removal or biopsy of orbital masses. The use of this technique for surgical excision of orbital masses in two dogs, one with an adenoma of the third eyelid gland and one with an orbital fibrosarcoma, and their subsequent management is described.

Scanning electron microscopy of intraocular lenses that had been implanted in dogs.

Scanning electron microscopy was used to evaluate changes on the surfaces of polymethylmethacrylate (PMMA), silicone, and polyhydroxyethylmethacrylate (HEMA) intraocular lenses (IOL) that had been implanted in the anterior chambers of the right eyes of 15 dogs. Five dogs received PMMA IOL; 5 dogs received silicone IOL; and 5 dogs received HEMA IOL. Twenty-eight days after surgery, the IOL were removed and processed for scanning electron microscopy. Nonimplanted IOL of each type were processed identically for comparison. Implanted PMMA IOL had significantly more debris and macrophages on their surfaces than did silicone IOL or HEMA IOL. Silicone IOL had significantly less fibrin deposition than did PMMA or HEMA IOL. Silicone IOL had surface defects attributable to handling by surgical instruments. Implanted HEMA IOL had multiple pits that appeared to be caused by biodegradation.

Clinicopathologic findings after experimental implantation of synthetic intraocular lenses in dogs.

Clinical findings indicate that canine eyes tolerate implantation of polymethylmethacrylate (PMMA) intraocular lenses (IOL) well, although inflammation and ocular damage attributable to the implants is not known. The use of silicone or polyhydroxyethylmethacrylate (HEMA) IOL has not been reported in dogs. In this study, 15 conditioned, mixed-breed dogs were allotted to 3 groups: 5 received PMMA IOL; 5 received silicone IOL; and 5 received HEMA IOL. The IOL optic was inserted into the anterior chamber of the right eye and anchored to the cornea. An identical surgical procedure was done on the left eye, except that no lens optic was inserted. Clinical examination and measurement of corneal thickness were done immediately prior to and after surgery. Aqueous humor samples were collected at the time of surgery and 28 days after surgery. Only mild and transient inflammation was observed in IOL-implanted eyes. On several postoperative days, it was found that PMMA IOL induced significantly greater corneal thickness, aqueous flare, anterior uveal irritation, and corneal edema than did other IOL. Significantly more anterior uveal irritation and increased aqueous humor protein concentration was observed with HEMA IOL than with PMMA or silicone IOL. Silicone IOL induced significantly less fibrin deposition than did PMMA or HEMA IOL.

Corneal thickness measured by ultrasonic pachymetry in cats.

Ultrasonic pachymetry was used to measure central, superior peripheral, and temporal peripheral corneal thickness of 35 cats (70 eyes) with normal corneas, anterior chambers, and intraocular pressures. Mean central corneal thickness for both eyes in 3 locations for 35 cats was 578 +/- 64 microns. Significant differences did not exist between central and peripheral corneal thickness. Corneal thickness increased significantly (P < 0.0001) with age up to 100 months. There was no significant difference in corneal thickness with regard to sex of the cats when adjusted for age.