Keratometry, biometry and prediction of intraocular lens power in the equine eye

OBJECTIVE: To determine ocular dimensions (A- and B-scan ultrasound) and corneal curvature (radius of corneal diameter determined in B-scan ultrasound) in the equine eye and to calculate the appropriate dioptric power for a posterior chamber intraocular lens (IOL) necessary to achieve emmetropia in the eyes of horses undergoing lens extraction. ANIMALS: Fourteen clinically normal adult horses of various breeds. Additionally, for comparison, one American Miniature colt foal, and one 2.5-year-old Shire gelding were examined. PROCEDURE: B-scan ultrasound was performed on one eye from each horse. One eye from both the Shire and the American Miniature were examined for comparison. Data from ultrasound (globe measurements and corneal curvature), and the estimated postoperative IOL positions were entered into theoretical IOL formulas (Binkhorst and Retzlaff theoretical formulas) in order to calculate the predicted IOL strength required to achieve emmetropia after lens extraction in horses. Results: Mean axial length of globes was 39.23 mm +/- 1.26 mm, mean preoperative anterior chamber depth (ACD) was 5.63 +/- 0.86 mm, and mean lens thickness was 11.75 +/- 0.80 mm. Predicted postoperative ACD (PACD) was calculated as the ACD plus 50% of the lens thickness. Additionally, PACD 2 mm anterior and 2 mm posterior to the center of the lens were calculated in order to evaluate the effect of IOL position on its required refractive power. Required IOL strength calculated, using the three values for the predicted postoperative ACD, was 29.91 D +/- 2.50, 29 D +/- 2.52 (center of lens); 27.13 D +/- 2.27, 26.33 D +/- 2.20 (2 mm anterior to center of lens); and 33.18 D +/- 2.78, 32.24 D +/- 2.68 (2 mm posterior to center of lens) with the Binkhorst and Retzlaff theoretical formulas, respectively. CONCLUSIONS: An IOL of substantially lower diopter strength than that needed in either dogs or cats is required to achieve emmetropia after lens extraction in adult horses. IOL strength of approximately 30 D, depending on where the IOL ultimately comes to rest, will probably be required.     

Retrospective study of 38 cases of femur fractures in horses less than one year of age.

Medical records of 38 horses less than 1 year of age and diagnosed as having a fracture of the femoral diaphysis, metaphysis or distal physis were evaluated. Twenty-six foals had fractures of the femoral diaphysis or metaphysis with the most common fracture configuration being comminuted. Twelve foals had distal physeal fractures with the most common fracture configuration being a Salter-Harris type II. Twenty-one foals with fractures of the capital femoral physis, neck or greater trochanter during the same time period were excluded from this study. Surgical repair was attempted in 16 diaphyseal and 2 distal physeal fractures. Most of the diaphyseal fractures were repaired by placing plates on the lateral and cranial surfaces of the bone. Dynamic condylar screw plates or angle blade plates were used for increased bone purchase in 4 foals with short distal fragments. Five foals with distal physeal fractures were treated; 2 were surgically treated by placing an angle blade plate on the lateral cortex, and 3 foals with minimally displaced distal physeal fractures were managed with stall confinement. Eight of the 16 surgically repaired diaphyseal fractures healed. Fracture location and configuration was not a determinant of outcome, but the mean age of foals with successfully repaired diaphyseal fractures was 2 months compared with 4 months for the unsuccessful cases, indicating that the age and size of the foal was important. Long-term follow up revealed that 6 of the 8 successfully repaired diaphyseal fractures had no residual effects of the fracture observed during performance of the horse for its intended use. Only 1 of the 2 surgically repaired distal physeal fractures healed, but this horse was eventually killed because of unthriftiness related to a malabsorption syndrome. Some form of complication developed in 13 of the 18 surgically repaired fractures. Infection was the primary cause of failure. The greatest determinant associated with infection was the inability to control post-surgical seroma formation.     

Phacoemulsification and implantation of foldable +14 diopter intraocular lenses in five mature horses

Presently, intraocular lenses (IOLs) are not routinely implanted after equine cataract surgery. Subsequently, horses are visual but markedly farsighted (hyperopic). This report describes the surgical results and visual status after phacoemulsification and implantation of IOLs in mature horses with spontaneous cataracts. Six eyes of 5 mature horses underwent phacoemulsification and implantation of a +14 diopter (D) foldable IOL. Recheck ocular examinations were performed at 1, 4 and 24 weeks post operatively. Refractive error was recorded at 4 weeks post operatively. Visual status, refractive error and anterior chamber depth were recorded 24 weeks post operatively: 5 of 6 operated eyes remained visual and the average refractive error was +0.4 ± 1.1D. There was a significant difference between the 24 week post operative refractive error and the population mean of +10D (P<0.0001) for aphakic horses. The average post operative anterior chamber depth was 7.89 ± 1.55 mm. One globe was enucleated 2 months post operatively. Phacoemulsification with IOL implantation resulted in a significant reduction in post operative refractive error and restored vision to within 0.4D of emmetropia in 5 of 6 operated eyes. Implantation of a +14D IOL ameliorated the hyperopia documented in aphakic horses and improved the post operative visual acuity.     

Fluorangiographic study of the ocular fundus in normal horses

Purpose:  To describe the protocol and appearance of fluorescein angiography (FA) in normal horses.
Animals:  A total of 25 healthy horses aged between 5 and 15 years.
Materials and Methods:  The horses were sedated with 15 µg/kg detomidine and 50 µg/kg butorphanol and dilated with topical tropicamide 1%. All angiograms were recorded after intravenous bolus injection of 10 mg/kg of fluorescein sodium solution.
Results:  Two successive angiographic phases could be discerned: the choriopapillary phase, starting at 46.95 ± 9.48 s, and the retinal vascular phase, starting at 47.79 ± 10.38 s. The retinal vascular phase was divided in three parts: filling phase , maximum fluorescence point , and fading phase . During the filling phase, the dye progressed into the retinal vessels, obtaining maximum fluorescence at 59.79 ± 10.39 s, termed the maximum fluorescence point. The fading phase started immediately following the maximum fluorescence point. During this phase, vascular fluorescence decreased to complete reduction at 74.76 ± 9.81 s. Also, areas of delayed choroidal filling, the presence of short retinal vessels in the ventral region of the optic disc, and a particular filling of the optic disc were also observed.
Conclusions:  The normal angiographic sequence was described in horses. FA may be a useful method for studying the integrity of the blood–retinal barriers in horses.     

Fluorangiographic study of the ocular fundus in normal horses

Purpose: To describe the protocol and appearance of fluorescein angiography (FA) in normal horses. Animals: A total of 25 healthy horses aged between 5 and 15 years. Materials and Methods: The horses were sedated with 15 µg/kg detomidine and 50 µg/kg butorphanol and dilated with topical tropicamide 1%. All angiograms were recorded after intravenous bolus injection of 10 mg/kg of fluorescein sodium solution. Results: Two successive angiographic phases could be discerned: the choriopapillary phase, starting at 46.95 ± 9.48 s, and the retinal vascular phase, starting at 47.79 ± 10.38 s. The retinal vascular phase was divided in three parts: filling phase, maximum fluorescence point, and fading phase. During the filling phase, the dye progressed into the retinal vessels, obtaining maximum fluorescence at 59.79 ± 10.39 s, termed the maximum fluorescence point. The fading phase started immediately following the maximum fluorescence point. During this phase, vascular fluorescence decreased to complete reduction at 74.76 ± 9.81 s. Also, areas of delayed choroidal filling, the presence of short retinal vessels in the ventral region of the optic disc, and a particular filling of the optic disc were also observed. Conclusions: The normal angiographic sequence was described in horses. FA may be a useful method for studying the integrity of the blood–retinal barriers in horses.     

Postmortem findings of gastric ulcers in Swedish horses older than age one year: a retrospective study of 3715 horses (1924-1996)

The present study was performed to estimate retrospectively the prevalence of gastric ulceration in necropsied Swedish horses and to evaluate some potential risk factors. Horses (n = 3715) older than age one year and necropsied 1924-1996 were included. Information about breed, gender, age, season of death, clinical signs of colic, Gasterophilus larvae and documentation of diseases in different organs was recorded. Data on size, number and anatomical distribution of gastric ulcers were also obtained. The cold-blooded horses and the Standardbreds were the 2 most dominating breeds in our material. Gastric ulcers/erosions were seen in 633 (17%) of the horses. The highest prevalence was found in Thoroughbreds (19%) and Standardbreds (19%), whereas only 7% of the cold-blooded horses were affected. The cutaneous region along the margo plicatus was the most commonly affected area (52%). Multiple ulcers were seen in 62% of the horses with gastric ulcers and concurrent ulcers in the oesophagus were reported in 6%. In the bivariate analysis, significant associations were found between gastric ulcers and signs of colic (P<0.001) and gender (P<0.001), as well as between concomitant bowel (P<0.001), liver (P<0.05) and oesophageal (P<0.01) lesions. Using a multivariate logistic regression model, only year of necropsy and breed were found significantly to influence the risk of gastric ulceration by decreasing the Log Likelihood test value. The present study shows clearly that gastric ulceration has been present in Swedish horses throughout the 20th century, which also may be the situation worldwide.     

大熊猫白内障手术临床研究

目的探讨大熊猫白内障摘除合并人工晶体植入手术技术。结果发现大熊猫白内障的晶体核硬度大,超声乳化吸除有困难;由于人与大熊猫眼球解剖结构有差异,人用人工晶体不适合大熊猫。结论需要对较大量的大熊猫进行无创性眼球检测,了解其眼睛的屈光状态和晶状体的屈光度,才能为研制大熊猫专用的人工晶体提供科学的依据。     

The use of magnetic resonance imaging for the assessment of distal limb wounds in horses: A pilot study

The utility of magnetic resonance (MR) imaging in the evaluation of equine solar foot penetrations is well established. The objective of this pilot study was to evaluate the utility of MR imaging in assessment of equine distal limb wounds excluding solar penetrations. Low-field MR images of 23 horses that had previously sustained distal limb wounds were reviewed in consensus by two ECVDI diplomats. Structures (bone; synovial structure; subcutaneous tissue and skin; and ligament/tendon) were identified as normal or abnormal on MR images, radiographs and ultrasound images and reports. All abnormalities were described. The presence of artefacts and their effect on image interpretation were also noted for each modality. Comparisons were made between imaging modalities, and it was noted if MR imaging influenced case management. Abnormalities of the bone were identified in 26% of horses on MR images and 17% of horses on radiographs; there were no osseous abnormalities identified on radiographs that were not identified on MR images, and additional features and better characterisation of lesions were noted on MR images. Tendon/ligament abnormalities were identified in 57% horses on MR and 47% of horses on ultrasound images. Magnetic susceptibility artefacts compromised MR image interpretation in 17% of horses. MR imaging of equine distal limb wounds allowed identification of both osseous and tendon/ligament abnormalities in more cases than either radiography or ultrasonography, and altered case management in 20/23 horses. Although MR imaging should not replace conventional imaging, this study highlights that MR imaging of equine distal limb wounds can yield information not detected on conventional imaging which may direct treatment and affect prognostication.     

Effect of single- and multiple-dose 0.5% timolol maleate on intraocular pressure and pupil size in female horses

OBJECTIVE: To determine the effect of single and multiple-dose 0.5% timolol maleate on intraocular pressure (IOP) and pupil size between 8 AM and 8 PM. Animals Nine female horses with normotensive eyes. Procedure IOP, horizontal and vertical pupil size were measured on a single day, between 8 AM and 8 PM at hours 0, 0.5, 1, 2, 4, 6, 8, 10, and 12. A single dose of 0.5% timolol maleate was applied to both eyes immediately after the first measurement at 8 AM. IOP and pupil size were measured at 8 AM and 4 PM in a 5-day experiment of twice-daily application of 0.5% timolol maleate. RESULTS: A significant decrease in IOP from 24.9 +/- 4.2 mmHg prior to application of timolol maleate to 20.7 +/- 3.1 mmHg (4.2 mmHg = 17%) was observed 8 h after single-dose application. A significant decrease in horizontal pupil size (2.0 mm = 11%) was present 6 h after single-dose application. In the multiple-dose experiment, a significant decrease in IOP was present on days 4 and 5 as compared to IOP measured prior to application of timolol maleate. A significant decrease in horizontal and vertical pupil size was present throughout the 5-day study as compared to the values obtained prior to treatment. CONCLUSIONS: 0.5% timolol maleate significantly decreased IOP and pupil size in normo-tensive eyes of this group of female horses in both single and multiple twice daily applications.     

A post-mortem study on the prevalence of peripheral dental caries in Scottish horses

Peripheral caries (PC) is an increasingly recognised equine dental disorder with unknown predisposing factors that differs from the well described maxillary cheek teeth infundibular caries. Advanced PC can lead to premature wear and fracture of cheek teeth and thus is of welfare importance. Recent studies have shown large variation in the prevalence of PC in different European countries, with a trend towards a greatly increasing prevalence. One hundred and one equine heads sourced from a Scottish rendering plant were examined for the presence and grade of PC using the modified Honma equine dental caries grading system. The presence of cheek teeth calculus, diastemata and fractures was also recorded. Peripheral caries was present in 91% of horses; only affected the cheek teeth and was predominantly (72.6%) Grade 1 Class 1 (localised pitting lesions only affecting cementum). The caudal three cheek teeth were more commonly affected (74.7% prevalence) as compared to the rostral three cheek teeth (32.1% prevalence). The palatal aspect of maxillary and the buccal aspect of mandibular cheek teeth were significantly (245% and 170%, respectively) more commonly affected by PC than the opposite sides. Female horses were more commonly affected than males. Because post-mortem examination allows the most detailed oral examination to be performed, this may partly explain the higher PC prevalence found in the current, as compared to previous studies, in addition to the particular population examined in this study.     

Thoracoscopic pericardiectomy: A feasibility study and impact on cardiac volumetry in healthy horses

This study was conceived to evaluate the feasibility of a thoracoscopic technique intended for partial pericardiectomy in horses and how cardiac volumes are influenced by such procedure in an immediate and mid-term perspective. Thoracoscopic pericardiectomy, which is known as a minimally invasive technique, was performed in six healthy horses. Echocardiographic evaluation was performed in every horse at different times, before and after the procedure. According to the area-length method, the following parameters were evaluated: maximum left atrial volume, minimum left atrial volume, left ventricular volume in systole and left ventricular volume in diastole. These variables were used to calculate the ejection fraction of the left atrium and left ventricle. After 28 days, repeated thoracoscopy was performed to inspect the thoracic cavity. Pericardiectomy was successfully performed in all horses, with post-operative complication documented in only one animal. After 28 days, adhesion was observed in two animals, located between the epicardium and the thoracic wall, without however impairing cardiac function. Pericardial window was broad and well delimited in all horses, without impairing cardiac function. The thoracoscopic pericardiectomy was feasible in all horses. Although a mild reduction in cardiac volumes was documented in the first 72 h after surgery, the procedure did not impair cardiac filling and emptying in the mid-term perspective. Future studies are warranted to investigate how this technique performs in horses with pericardial diseases.     

A pilot study on the use of ultra-deformable liposomes containing bleomycin in the treatment of equine sarcoid

The efficacy of a novel topical liposome-encapsulated preparation of bleomycin (Bleosome) was studied in 118 clinical cases of equine sarcoid and efficacy was compared with two other standard conventional treatments, tazarotene and 5-fluorouracil (5-FU) as well as with the Bleosome in combination with each of these two conventional treatments. Treatments were arbitrarily assigned. Fifty-two of the 118 sarcoids (44%) were resolved after 12 months but there were significant differences between treatment groups with the combinations of either 5-FU and bleomycin, or tazarotene and bleomycin resulting in significantly superior resolution of 77 and 78% of the lesions, respectively. The preliminary results suggest that bleomycin in a liposomal carrier may be a useful treatment modality for superficial, diffuse and verrucose sarcoids. The treatment process was simple, and outcomes were functionally and cosmetically excellent. Liposome-encapsulated bleomycin is economic compared to radiation and other treatment options and can be applied effectively by the owner under guidance. Further studies with different administration protocols and higher concentrations of bleomycin are warranted.     

B‐mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses

Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B‐mode findings with power Doppler findings in suspensory ligament branches of lame and non‐lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non‐lame horses). Ten lame limbs and 24 sound limbs were assessed by B‐mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B‐mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B‐mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B‐mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B‐mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy.