Preliminary report of postoperative complications of phacoemulsification in Pugs: A multicenter retrospective study of 32 cases.

OBJECTIVE: To compare complication rates and visual outcomes following phacoemulsification in Pugs versus dogs of other breeds. ANIMALS STUDIED: Thirty-two pure-bred Pugs (55 eyes) and 32 dogs of other breeds (56 eyes) undergoing phacoemulsification. PROCEDURES: Multi-institutional retrospective medical record review of perioperative factors, postoperative complications, and visual outcomes. The reference population of dogs of varying breeds included surgical cases following each Pug case at the same institutions. Perioperative risk factors and postoperative complication rates were compared between the two populations. RESULTS: Pigmentary keratitis and diabetes mellitus were the most common preoperative comorbidities, found in 75% (P < .001) and 72% (P = .12) of Pugs, respectively. No perioperative factors were significantly associated with postoperative complications in Pugs. Postoperative complication rates were similar between groups; however, the most common complication in Pugs was corneal ulceration (15% of operated eyes), whereas glaucoma was most common in the reference population (13% of operated eyes). Three months postoperatively, vision was preserved in 91% of eyes of Pugs (50/55) and 95% of the reference population (53/56). One year postoperatively, 80% (32/40) of Pug eyes and 82% (28/34) of eyes in the reference population remained sighted. CONCLUSIONS: Comorbidities and complications of cataract surgery in Pugs of this study demonstrate a predisposition for corneal disease. This highlights the importance of preoperative evaluation of factors associated with PK and corneal clarity, and postoperative monitoring for corneal ulceration in this breed.

Determination of trypan blue efficacy in the mitigation of ex vivo canine PCO formation.

PURPOSE: To determine whether trypan blue (TB) reduces canine lens epithelial cell (LEC) or corneal endothelial cell (CEC) viability in vitro; if cell death is noted, to subsequently evaluate the molecular mechanism. METHODS: Cellular viability was determined using a lactate dehydrogenase (LDH) assay. In TB-treated LECs, caspase 3/7 activity was assessed to evaluate apoptosis; autophagy was evaluated using immunoblotting against LC3 and p62. To evaluate the effects of TB on ex vivo posterior capsule opacification (PCO), following mock cataract surgery, lens capsules were treated with TB and subsequently maintained in culture to determine LEC migration and proliferation. RESULTS: Following acute exposure, TB did not significantly reduce LEC or CEC viability at any of the concentrations tested. Increased caspase 3/7 activity was found in LEC cultures treated with TB for an extended period of time; no change in LC3 or p62 expression was noted. Ex vivo PCO formation was not significantly altered by TB treatment. CONCLUSIONS: Acute exposure to TB did not reduce LEC or CEC viability, and only longer exposure to TB was able to initiate apoptosis. Treatment with intraocular TB at the time of cataract surgery is likely safe to the CECs but will not prevent PCO formation.

Effects of grape seed extract, lutein, and fish oil on responses of canine lens epithelial cells in vitro.

OBJECTIVE To determine the effects of grape seed extract (GSE), lutein, and fish oil containing omega-3 fatty acids on oxidative stress, migration, proliferation, and viability of lens epithelial cells (LECs). SAMPLE Lens capsules or cultured LECs obtained from canine cadavers. PROCEDURES An antioxidant reductive capacity assay was used to determine reducing capability of each substance. The LECs were cultured and incubated with various substances, including N-acetyl cysteine (NAC), when appropriate, and dimethyl sulfoxide (DMSO) as positive and vehicle control substances, respectively. A dichlorofluorescein assay was used to evaluate reactive oxygen species (ROS) production, and a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to determine cell viability. Ex vivo posterior capsule opacification (PCO) was used to evaluate LEC migration and proliferation. RESULTS Antioxidant reductive effects of GSE surpassed those of NAC, lutein, and fish oil containing omega-3 fatty acids. The GSE reduced ROS production in LECs, compared with the DMSO vehicle control, whereas lutein was pro-oxidative. All test substances reduced cell viability. Ex vivo PCO was not altered by GSE, was decreased by lutein, and was increased by fish oil containing omega-3 fatty acids, compared with results for the DMSO vehicle control. CONCLUSIONS AND CLINICAL RELEVANCE Only GSE had significant antioxidant capabilities and reduced ROS production; however, no effect on ex vivo PCO was detected. Fish oil containing omega-3 fatty acids increased ex vivo PCO. No conclusions could be made regarding antioxidant effects of these substances on LECs. These findings suggested that the substances will not decrease PCO.

The Neuroprotective and antioxidative effects of submicron and blended Lycium barbarum in experimental retinal degeneration in rats.

The object is to determine the neuroprotective and antioxidative effects of submicron and blended Lycium barbarum (LB) on retinal degeneration as evaluated by ERG, retinal histopathology and assays of antioxidant (total GSH) and peroxidant (MDA) in the retina. A rat model of light-induced retinal degeneration was used to assess the protective effect of different forms of Lycium barbarum (LB) on retinal degeneration. Rats were divided into four experimental groups, normal control, light-induced untreated, submicron LB and blended LB treated. The rats of submicron and blended groups were treated with 250 mg/kg LB orally once daily for 54 days, followed by induction of retinal degeneration. Retinal function was assessed by electroretinography (ERG). Enzyme-linked immunosorbent assay of the retina lysates was measured for the levels of antioxidants, reduced glutathione and glutathione disulfide, and peroxidants, malondialdehyde, in the retina. The ERG results showed a protective effect in LB treated groups with a greater effect observed in submicron LB treated group than the blended LB treated group. There were higher levels of GSH plus GSSG and lower MDA in submicron LB treated group than other groups. In conclusion, LB provided protective and antioxidative effects on the rat retina with light-induced retinal degeneration. Submicron LB protected degenerative retina better than blended LB. LB is effective against oxidative stress in the degenerative retina.

Use of an intravenous sclerosing foam (3% sodium tetradecyl sulfate) for treatment of orbital varix in a dog.

A 6-month-old intact male Standard Dachshund was referred for evaluation of a soft tissue swelling above the right eye. Examination of the right eye revealed mild lateral deviation of the globe, normal vision, and a dorsonasal soft tissue swelling. Examination of the posterior segment was normal. Dual-phase computed tomography angiography was consistent with an orbital varix of the angularis oculi and right dorsal external ophthalmic veins with no evidence of arterial involvement. Treatment involved fluoroscopically guided coil embolization of the venous outflow with nine platinum microcoils, followed by sclerotherapy of the varix using 1.5 mL of 3% sodium tetradecyl sulfate foam. Moderate-to-marked swelling was noted at the treatment site in the weeks following therapy, which gradually resolved. At final reexamination 3 months post-therapy, complete sclerosis and resolution of the orbital varix were documented. To the authors' knowledge, this is the first reported case involving the use of a sclerotic agent for successful treatment of a venous malformation in a dog.

Glaucoma with Descemet's membrane detachment in five horses.

PURPOSE: To describe the clinical and histopathologic features of glaucoma associated with Descemet's membrane (DM) detachment in five horses without prior history of intraocular surgery. ANIMALS STUDIED: Three Appaloosa horses and two Thoroughbreds were included in this study. The affected horses ranged in age from 16 to 27 years and presented with severe diffuse corneal edema. PROCEDURE: Five eyes were enucleated due to intraocular hypertension and/or chronic corneal ulceration. The enucleated globes were evaluated by the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW). Each globe was routinely processed for histopathology and analyzed by light microscopy. A histologic diagnosis of glaucoma was reached by demonstrating a loss of optic nerve axonal tissue by measuring neurofilament-immunopositive axons with automated image analysis software. RESULTS: All five horses presented with unilateral severe diffuse corneal edema that had developed between 2 and 16 weeks prior to enucleation. Intraocular pressures for the affected eyes were between 9 and 87 mmHg prior to enucleation. Descemet's membrane detachment was identified histopathologically in all five globes (5/5, 100%). All five eyes had an avascular spindle cell proliferation filling the space between the displaced peripheral DM and the corneal stroma. Neurofilament immunostaining revealed axonal loss consistent with glaucoma. CONCLUSION: Equine glaucoma may be associated with Descemet's membrane detachment. This detachment and glaucoma is a possible differential diagnosis for severe equine corneal edema. In this case series, an eye with a DM detachment had a poor prognosis for retention.

An association between systemic cyclosporine administration and development of acute bullous keratopathy in cats.

OBJECTIVE: To determine whether any association exists between the onset of feline acute bullous keratopathy (ABK) and administration of systemic corticosteroid or immunosuppressive therapy. ANIMALS STUDIED: Medical records of cats diagnosed with ABK between the years of 2000 and 2008 were retrospectively reviewed. Breed, age at diagnosis, weight, systemic disease status, eye affected, ophthalmic examination findings, systemic and topical therapy instituted, dosage and duration of therapy, visual outcome and histopathological analyses were recorded in cases meeting the inclusion criteria. RESULTS: A total of 12 cats of a surveyed population of 70 167 met the inclusion criteria with 17/24 eyes affected by ABK. Medical and/or surgical therapy was utilized for management of ABK with 13/17 eyes remaining sighted at the time of last follow-up. In a subset of cases corneal cytology, aerobic bacterial culture, FHV-1 PCR, virus isolation and/or histopathology were performed; no infectious organisms were identified. A rupture in Descemet's membrane of the cornea was identified histologically in two globes. A total of 10 of 12 cats had been previously diagnosed with ongoing systemic disease. A total of 10 of 12 cats were receiving systemic therapy, and a significant association (P < 0.001) was noted between systemic administration of corticosteroids and/or cyclosporine A and the development of ABK. A total of 8 of 10 cats were administered oral prednisolone at doses between 1-2 mg/kg every 12-24 h. A total of 5 of 8 cats receiving oral prednisolone were concurrently administered oral cyclosporine at doses of 1.5-7 mg/kg every 12-24 h. Systemic cyclosporine therapy was found to be a significant risk factor (P < 0.001) for ABK development, while systemic prednisolone was not significant (P = 0.10). CONCLUSIONS: Systemic cyclosporine administration appears to be a risk factor for development of ABK in the population of cats studied.

Cyclosporine A prevents ex vivo PCO formation through induction of autophagy-mediated cell death.

The purpose of this study was to determine the Cyclosporine A (CsA) dose and minimum drug delivery time needed to prevent posterior capsule opacification (PCO) in an ex vivo canine model and evaluate the mechanism of CsA-induced cell death. Canine lens epithelial cells (LEC) were treated with CsA and changes in cell migration, proliferation, and density were monitored over time. CsA-treated LEC underwent transmission electron microscopy (TEM), immunofluorescence, and immunoblotting in the presence or absence of autophagy inhibitors to evaluate the mechanism of cell death. Lens capsules were harvested from canine cadaver eyes for an ex vivo model of PCO. Lens capsules were treated with CsA for 1, 2, 3, 4, 5, 6, or 7 days, and subsequently maintained in culture for a total of 28 days in the absence of drug. CsA reduced LEC viability in a dose dependent manner. Morphologically, CsA-treated LEC were swollen, had intact nuclei, lacked peripheral chromatin condensation, and demonstrated prominent vacuolization; TEM revealed autophagosomes. LC3-II protein expression and acridine orange fluorescence increased in CsA-treated cells. A small non-significant induction of cleaved caspase-3 was observed in CsA-treated LEC. Lens capsules treated with 5, 6, or 7 days of 10 µg/mL CsA showed a significant decrease in ex vivo PCO formation; 6 days of drug delivery prevented PCO. This study finds that morphologic changes, formation of acidic vesicles, and increased expression of LC3-II supports the hypothesis that CsA mediates LEC death via autophagy; this is a novel finding in the lens. Induction of CsA-induced apoptosis was minimal. Six days of intracapsular CsA drug delivery prevented ex vivo PCO formation.

Retrospective study of the prevalence of keratoconjunctivitis sicca in diabetic and nondiabetic dogs after phacoemulsification.

OBJECTIVE: To evaluate the prevalence of keratoconjunctivitis sicca (KCS) in diabetic and nondiabetic dogs following phacoemulsification. PROCEDURES: Medical records were reviewed for signalment, body weight, diabetes status, and STT at the preoperative and all postoperative examinations. A clinical diagnosis of KCS was defined as a STT <15 mm/min with compatible clinical signs. Schirmer tear test values and the prevalence of KCS based on STT <15 mm/min were evaluated at 2-4, 5-8, 9-14, 15-20, and 41-52 weeks postoperatively. Size of dog (large, >10 kg; small, ≤10 kg) and STT ranges (<15 mm/min, 15-22 mm/min and >22 mm/min) were categorized for analysis of effect of body weight and STT on prevalence of KCS. RESULTS: One hundred and seventeen nondiabetic (198 eyes) and 118 diabetic dogs (228 eyes) were evaluated. KCS was diagnosed in nearly twice as many diabetics as nondiabetics (27.4% vs. 15.4%) within 2 weeks postoperatively (P = 0.0088). Percentage of eyes with KCS among all dogs decreased over time and did not differ significantly after the first postoperative visit. Diabetic small dogs were 1.7 times more likely to have KCS than nondiabetic small dogs (P = 0.0052). Preoperative STT was significantly associated with likelihood of postoperative KCS among large (P < 0.0001), but not small dogs (P = 0.0781). Among large dogs, eyes with STTs between 15 and 22 mm/min were approximately 3 times more likely to be diagnosed with KCS after surgery than those with STT >22 mm/min. CONCLUSION: The greatest risk for KCS for all dogs is during the first 2 weeks postoperatively. Populations at greatest risk for postoperative KCS are small dogs, small diabetic dogs, and large dogs with preoperative STT ≤22.

Safety study of capsular tension ring use in canine phacoemulsification and IOL implantation.

OBJECTIVE: To evaluate and compare surgical outcome and complications in canine eyes with stable, cataractous lenses undergoing routine phacoemulsification and intraocular lens (IOL) implantation with or without implantation of a capsular tension ring device (CTR). PROCEDURES: Dogs undergoing routine bilateral phacoemulsification and IOL implantation had one eye randomly chosen to have a CTR (47 eyes) inserted while the contralateral eye served as a control (47 eyes). The CTR was placed in the capsular bag following phacoemulsification and immediately prior to IOL implantation. All eyes received acrylic foldable IOLs. Patients were evaluated intra- and postoperatively, and complications were compared between eyes with and without a CTR. RESULTS: There were no intra-operative complications associated with implantation of the CTR. Postoperatively, the overall incidences of glaucoma (6%), intraocular hemorrhage (4%), and retinal detachment (2%) were equal between control and CTR eyes at the time of last follow-up. There was no significant difference in overall incidence of immediate postoperative uveitis (35% vs. 38%) or fibrin (19% vs. 15%) between control and CTR eyes. Follow-up time ranged from 2 weeks to 21 months. CONCLUSION: In canine eyes with stable cataractous lenses undergoing routine phacoemulsification and IOL implantation placement of a CTR does not increase the risk of intra- or postoperative complications.

Effects of pulsed fluid lens capsule washing following phacoemulsification on lens epithelial cells and posterior capsule opacification formation ex vivo.

BACKGROUND: The aim of the study was to evaluate ex vivo the effects of using a custom tip to direct a pulsed stream of fluid to remove residual lens epithelial cells (LECs) and reduce posterior capsule opacification (PCO) formation following phacoemulsification. METHODS: Twenty-four canine cadaver eyes were assigned to one of three treatment groups. Six eyes (Control Group) had standard phacoemulsification only, nine eyes (Group 1) had standard phacoemulsification followed by capsular washing using intermediate settings (power = 40%, pulses per second [PPS] = 50, 30 s washing per capsule hemisphere), and nine eyes (Group 2) had standard phacoemulsification followed by aggressive capsular washing (power = 60%, PPS = 50, 60 s washing per capsule hemisphere). RESULTS: Control lens capsules had diffuse LECs remaining following standard phacoemulsification and complete ex vivo PCO formation (confluent LECs on the posterior capsule) within 4 ± 2 days (range 2-8 days). Group 1 lens capsules had focal, equatorial LEC clusters remaining following treatment, and complete PCO formation within 9 ± 2 days (range 5-11 days). Group 2 lens capsules had little to no LECs observed following treatment; 5 of 9 capsules had complete PCO formation within 13 ± 2 days (range 9-14 days), and 4 of 9 capsules had no PCO formation by 24 days post-treatment. CONCLUSIONS: Pulsed fluid lens capsule washing is capable of removing LECs and delaying PCO formation in canine eyes following phacoemulsification ex vivo. Use of more aggressive capsular washing settings resulted in more effective LEC removal and subsequent delay of ex vivo PCO.

The location of sites and effect of semiconductor diode trans-scleral cyclophotocoagulation on the buphthalmic equine globe.

PURPOSE: To determine appropriate location and energy settings for trans-scleral cyclophotocoagulation (TSCPC) for buphthalmic equine globes. ANIMALS: Eleven horses with a buphthalmic eye blinded by glaucoma presented for enucleation. METHODS: Globe and corneal dimensions were measured via ultrasonography and calipers, and TSCPC was performed under general anesthesia immediately prior to enucleation. Part 1: In nine globes, sixty sites were lasered 4 mm posterior to the limbus in the dorsotemporal and ventrotemporal quadrants at settings of 1500 milliwatts and 1500 ms. Globes were processed and sectioned sagitally over the temporal aspect in two blocks, each with five histologic sections examined by light microscopy. A digital imaging system was used to determine the location and length of the pars plicata on one slide from each block. Part 2: Based on results in Part 1, two globes were measured and lasered using the same time and energy settings at the following distances posterior to the limbus: 8 mm dorsally, 6 mm dorsotemporally, 5 mm ventrotemporally, and 5 mm ventrally. RESULTS: Globe and corneal dimensions exceeded normal values in all globes. Part 1: In all nine globes, photocoagulation affected the anterior ciliary processes and iris base and in 8/9 coagulation of the pectinate ligaments was noted. Part 2: In both globes, coagulation was confined to the pars plicata. CONCLUSIONS: The previously recommended TSCPC sites are located too far anteriorly for a buphthalmic globe. Buphthalmic equine globes should have TSCPC performed at the following distances posterior to the limbus: 6-8 mm dorsally, 5-6 mm dorsotemporally, 4-5 mm ventrotemporally, and 4-5 mm ventrally.

Evaluation of potential topical and systemic neuroprotective agents for ocular hypertension-induced retinal ischemia-reperfusion injury.

OBJECTIVE: To evaluate for drugs with superior neuroprotective efficacy and investigate their underlying mechanisms related to antioxidation. PROCEDURES: Brinzolamide (1%), timolol (0.5%), minocycline (22 mg/kg), lidocaine (1.5 mg/kg), and methylprednisolone (30 mg/kg) were administered to Sprague-Dawley (SD) rats. The retina was evaluated by electroretinography and histological analysis. The antioxidative capacity of drugs was evaluated to clarify the underlying mechanism. The oxidant/antioxidant profiles of plasma, red blood cells, and retina were analyzed by lipid peroxidation (malondialdehyde) and by measuring the activities of antioxidants. Proteomic analysis was used to investigate the possible protective mechanisms of the drug against ischemia-reperfusion injury. RESULTS: The results suggested that timolol, methylprednisolone, and minocycline protected retinal function. Methylprednisolone and minocycline possessed good antioxidative activity. Brinzolamide and lidocaine preserved the structural integrity of the retina, but not retinal function. CONCLUSION: Methylprednisolone, minocycline, and timolol have potential acute or delayed benefit in retinal ischemia-reperfusion injury. Their neuroprotective actions depend at least partially on the ability to alleviate oxidative stress.

Equine glaucoma: a histopathologic retrospective study (1999-2012).

PURPOSE: To characterize and describe the histopathologic findings in equine globes enucleated due to glaucoma. METHODS: Medical records at The Ohio State University from 1999 to 2012 were reviewed retrospectively. Signalment, history, and treatment data were collected, and histologic slides of enucleated globes were examined and lesions recorded. Twenty-three eyes from 23 horses were eligible for inclusion in this study. RESULTS: The majority of affected horses were > 15 years of age (65%). The ages ranged from 5 to 35 years (mean = 17.4 years). The left eye was affected in 10 cases (43%) and the right eye in 13 cases (57%). There were 13 mares (56%) and 10 geldings (44%). Quarter Horses (30%), Appaloosas (26%), and Thoroughbreds (22%) were the most common breeds in the study population. The most common histopathologic changes included hypercellularity of the optic nerve (93%), retinal atrophy (89%), corneal vascularization (83%), descemetization of pectinate ligaments (83%), hypercellularity of the anterior corneal stroma (75%), posterior bowing of the iris base (74%), ciliary body atrophy (74%), corneal striae (70%), pars plana elongation (60%), cataract (53%), and collapsed ciliary cleft/trabecular meshwork (52%). Evidence of uveitis (cataract, lymphoplasmacytic infiltration of the uvea, and/or anterior or posterior synechiae) was present in 20/23 eyes (87%). CONCLUSIONS: Equine glaucoma most commonly occurs secondary to uveitis with Appaloosas and older horses predisposed. Histologic changes are comparable to prior reports of chronic glaucoma; notable findings not previously described in the horse were posterior bowing of the iris base and relative sparing of the superior retina from atrophy associated with elevated IOP.

Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices.

PURPOSE: 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.

Extraocular lymphoma in the horse.

OBJECTIVE: To describe the clinical findings and prognosis for extraocular lymphoma in the horse. PROCEDURES: Retrospective medical records study of horses diagnosed with third eyelid, corneoscleral, conjunctival, and/or eyelid lymphoma from multiple academic and private veterinary institutions. Data collected from the medical records included signalment, clinical descriptions of the extraocular lesions, treatment, and treatment outcomes. Nonparametric statistical analysis was performed with Fischer's exact tests. RESULTS: Extraocular lymphoma involving the eyelid, third eyelid, cornea, sclera, and/or conjunctiva was diagnosed in 26 horses. Differences in signalment, unilateral vs. bilateral extraocular involvement, and single vs. multiple extraocular lesion locations held no significance in terms of outcome. ANIMALS STUDIED: Horses with lesions localized to the eyelid or other nonextraocular cutaneous locations had a significantly higher chance of negative outcome when compared to the horses with no eyelid or cutaneous involvement (P = 0.019). Lesions to the third eyelid, corneosclera, and conjunctiva were either nodular or diffuse in nature. Nodular lesions when compared to diffuse lesions were associated with a higher chance of a positive outcome (P = 0.007). Surgical resection of the extraocular lesions as part of the treatment produced a statistically higher chance of a positive outcome when compared to horses where resection was not performed (P = 0.03). CONCLUSIONS: The prognosis for clinical remission in horses with extraocular lymphoma is generally fair to good, as long as the affected tissues are completely excised, and there is no eyelid or cutaneous involvement. Horses diagnosed with the nodular form of extraocular lymphoma seem to have the best prognosis with complete excision.

Actinomyces bowdenii ulcerative keratitis in a dog.

A 5-year-old spayed female diabetic mixed-breed dog underwent phacoemulsification and intraocular lens implantation to correct bilateral hypermature cataracts. Two months postsurgery, the patient presented with ulcerative keratitis and multifocal stromal abscessation OD, which was controlled, but never resolved, with topical fluoroquinolone therapy. The patient re-presented 2 months later with a new, raised, white gritty corneal opacity associated with hyperemia, chemosis, and blepharospasm OD. Cytology of the right cornea revealed filamentous bacteria, suggestive of Actinomyces spp. Actinomyces bowdenii was subsequently isolated in pure culture and identified via 16s rDNA sequencing. Actinomyces bowdenii has never before been described as a cause of ocular infection. An immunosuppressed corneal environment likely contributed to this opportunistic Actinomycosis. The infection was not controlled with fluoroquinolone therapy, and the isolate, in vitro, was resistant to three fluoroquinolones (ciprofloxacin, ofloxacin, and levofloxacin), which also has not been previously reported for this species of Actinomyces. A superficial keratectomy with conjunctival graft was employed to successfully manage the infection.

A topical aqueous calcineurin inhibitor for the treatment of naturally occurring keratoconjunctivitis sicca in dogs.

PURPOSE: The purpose of this study was to evaluate the efficacy of an aqueous calcineurin inhibitor, SCY-641, in the treatment of naturally occurring canine immune-mediated keratoconjunctivitis sicca (KCS). METHODS: A randomized, double-masked, placebo-controlled clinical study of 56-day duration was performed in dogs with naturally occurring immune-mediated KCS assigned to treatment with either topical twice-daily aqueous calcineurin inhibitor solution (SCY-641) or artificial tears (placebo) by the study administrator. Clinical examination and Schirmer tear tests (STT) were performed prior to therapy and at days 7, 14, 28, and 56 after initiation of treatment. RESULTS: Twenty dogs were enrolled in the study with ten receiving placebo and 10 receiving SCY-641 in one or both eyes. No adverse effects were noted with any treatment. There were no significant differences in mean STT values in dogs in group either at day 0 (prior to therapy) or after 7 days of treatment. At 14, 28, and 56 days after initiation of treatment, mean STT and increase in STT over baseline in dogs treated with SCY-641 were significantly higher than in dogs treated with placebo (P < 0.04). CONCLUSIONS: SCY-641 was well tolerated by dogs with naturally occurring KCS, and by 14 days after initiating therapy, dogs treated with SCY-641 had significantly higher STT than placebo-treated dogs. These preliminary results indicate that topical SCY-641, in a stable clear aqueous solution, is efficacious in a spontaneous model of KCS and warrants further evaluation as a treatment of immune-mediated KCS.

Induction of posterior capsule opacification by hyaluronic acid in an ex vivo model.

PURPOSE: Because hyaluronic acid (HA) is found in many surgical viscoelastic agents, this study aimed to determine (1) if HA receptors are present in the canine lens, (2) if the rate of lens epithelial cell (LEC) migration is altered following treatment with HA, and (3) if introduction of exogenous HA into the lens capsule promotes lenticular migration, thus contributing to posterior capsule opacification (PCO). METHODS: Normal and cataractous canine LECs were evaluated for expression of the HA receptor CD44 and the receptor for HA mediated motility (RHAMM) using immunohistochemistry, immunoblotting, and real-time PCR. Canine LEC were treated with various concentrations of HA, and induction of migration was monitored over time. Commercially available surgical viscoelastics were utilized ex vivo, and rates of PCO formation were analyzed. RESULTS: Basal protein and mRNA expression of both CD44 and RHAMM was noted. Cataractous canine LEC demonstrated significantly (P < 0.01) higher expression of CD44 but not RHAMM. Treatment with higher concentrations of HA resulted in a significant (P < 0.01) increase in CD44 mRNA and increased LEC migration in vitro. Use of CD44-neutralizing antibodies confirmed the role of CD44 in HA-induced lenticular migration. Viscoelastic material containing higher concentrations of HA led to increased rates of ex vivo PCO. CONCLUSIONS: Exogenous HA can induce lenticular migration and CD44 expression. Use of surgical viscoelastics that contained HA resulted in increased rates of ex vivo PCO suggesting that judicious selection and use of viscoelastic material during cataract surgery is warranted.

The long-term effects of semiconductor diode laser transscleral cyclophotocoagulation on the normal equine eye and intraocular pressure(a).

OBJECTIVE: To describe the long-term histologic and intraocular pressure (IOP) lowering effects of diode laser transscleral cyclophotocoagulation (TSCP) on the normal equine eye. ANIMALS: Eight normal adult horses. PROCEDURES: TSCP was performed in one randomly assigned eye. Sixty spots were treated at settings of 1500 ms and 1500 mW. Two horses were randomly selected for euthanasia at 2, 4, 12, or 24 weeks post-TSCP. Both eyes were enucleated and histologically evaluated. Intraocular pressure was measured by applanation tonometry prior to TSCP, immediately post-TSCP, twice daily for 7 days post-TSCP and then monthly until study conclusion. A longitudinal model estimated the average IOP values for the treated and untreated eyes at 1 week, 1, 3, and 6 months post-TSCP. RESULTS: All treated eyes at all time periods exhibited four characteristic histologic lesions: scleral collagen hyalinization, ciliary body pigment dispersion and clumping, focal disruption of the ciliary body epithelium, and focal ciliary process atrophy. After TSCP, there were no significant changes in IOP from baseline for the control eyes, while the IOP in treated eyes was significantly decreased from baseline (P < 0.05) at all time periods. The estimated decrease in IOP in the treated eyes compared to baseline IOP at 6 months was -3.76 mmHg for an average decrease in IOP of 20% from baseline. CONCLUSION: Diode laser TSCP produces histologic lesions in the equine ciliary body that result in a significant and sustained decrease in IOP. TSCP may be an effective management for equine glaucoma.