Transpalpebral eye enucleation in 40 standing horses

Objective— To report a technique for eye enucleation in standing sedated horses and to report outcome in 40 horses.
Study Design— Retrospective study.
Animals— Horses (n=40) requiring eye enucleation.
Methods— The eye was enucleated using a transpalpebral technique in 40 horses restrained in stocks and sedated. Anesthesia of orbital structures was provided by local nerve blocks and infiltration of the surgical site with local anesthetic solution.
Results— Affected eyes were successfully enucleated with the horse standing. Short-term complications included moderate swelling (5 horses) and wound discharge (1). Long-term complications were not observed.
Conclusions— A diseased eye can be safely enucleated with a horse standing.
Clinical Relevance— Enucleating an equine eye in the standing position eliminates the risks and costs of general anesthesia.     

Computed Tomography and Magnetic Resonance Anatomy of the Normal Orbit and Eye of the Horse

Traumatic and infectious diseases of the eye and orbit can occur in horses. For diagnosis and monitoring of such diseases, medical imaging is useful including computed tomography (CT) and magnetic resonance imaging (MRI). The aim of the current study was to describe CT and MRI anatomy of the equine orbit and ocular globe. The heads from four adult horses were scanned with a 6‐slice Emotion 6 CT (Siemens, Erlangen), and a 3.0 Tesla Siemens Verio 6 MRI using T1 and T2‐weighted sequences. To validate CT and MR reference images, these were compared with anatomical models and gross anatomical sections. The bony limits of the orbital cavity, the relationship of the orbit with sinuses and foramina of the skull were well identified by CT. MRI was useful to observe soft tissues and was able to identify adnexae of the ocular globe (eyelids, periorbital fat, extraocular muscles, lacrymal and tarsal glands). Although MRI was able to identify all components of the eye (including the posterior chamber), it could not differentiate sclera from choroid and retina. The only nerve identified was the optic nerve. Vessels were not seen in this series of cadaver heads. This study showed that CT and MRI are useful techniques to image the equine orbit and eye that can have clinical applications.     

A pilot study on the corneal curvatures and ocular dimensions of horses less than one year of age

Intraocular lenses (IOLs) have been implanted in adult equine eyes after cataract surgery. Foals and weanlings comprise a large proportion of those horses undergoing cataract surgery. Due to potential differences in the size and corneal curvature of the juvenile eye, it is not currently known whether implantation of adult IOLs is appropriate in foals and weanlings. The objective of the study was to measure the anterior chamber depth (ACD), central lens thickness (CLT), vitreous chamber depth (VCD), axial globe length (AGL) and corneal curvature of horses less than one year of age. The axial dimensions from one eye of 10 foals were measured using simultaneous A and B scan ultrasonography. The corneal curvature from one eye of 7 weanlings was determined using a modified photokeratometer. Ultrasonography revealed a mean ACD of 4.94 mm, mean CLT of 9.38 mm, mean VCD of 18.96 mm and mean AGL of 33.32 mm for the foals. The mean corneal curvature was 15.4 diopters (D). The mean ACD, CLT, VCD and AGL of the foals were less than the measurements reported in the literature for adult horses. The mean corneal curvature was similar to the values reported by some authors for adult horses. Due to the differences in axial dimensions between adult and juvenile eyes, an IOL that corrects vision in an adult horse might not adequately correct vision in a horse less than one year of age.     

Topography of ganglion cells in the retina of the horse

Topography of ganglion cells in the retina of the horse (Thoroughbred) was analyzed in the wholemount retina stained with cresyl violet, and a total number of ganglion cells were estimated. Sizes of ganglion cells were also measured and size spectra were analysed. The main results showed that: (1) a common point in 4 wholemount retinae, based on cell densities and retinal locations, was that a retina could be divided into 5 regions, namely visual streak, nasal, temporal, dorsal and ventral region to the visual streak. A maximum cell density of 4,000 cells/mm2 was found in the visual streak. And a total number of ganglion cells was estimated in a range of 398 x 10(3) - 469 x 10(3), with a mean of 441 x 10(3) +/- 31 x 10(3) (n=4). (2) cell sizes were measured as the mean lengths of the major and minor axes of the somas, and were in a range of 5-53.8 microm. The lowest mean diameter was 14.0 microm (+/- 3.7) in the visual streak and the highest was 25.9 microm (+/- 7.6) in the ventral region. Cell size spectra were unimodal and positively skewed. It is expected that these analyses will provide an anatomical and physiological background for further study of the visual system in the horse.     

Aqueous humor and plasma concentrations of a compounded 0.2% solution of terbinafine following topical ocular administration to normal equine eyes

Objective To determine the transcorneal penetration and systemic absorption of a compounded 0.2% terbinafine solution following repeated topical administration to normal equine eyes. Sample population Six healthy adult horses with normal ocular examinations. Procedures One eye of each horse received 0.2 mL of a compounded 0.2% terbinafine solution every 4 h for seven doses. During the 1 h following administration of the final dose, multiple peripheral blood samples were obtained, and a single aqueous humor (AH) sample was collected at the end of the hour. AH and plasma concentrations of terbinafine were determined using high pressure liquid chromatography (HPLC). Stability of the formulation was assessed with HPLC analysis over a 14‐day time period. Results Terbinafine was not detected in the AH or plasma of any horse at any time point. No signs of ocular irritation or systemic toxicity were noted in any horse at any time point. The solution was stable over 14 days. Conclusion Topical ocular administration of compounded 0.2% terbinafine solution does not result in detectable AH or plasma levels following administration to normal equine eyes, suggesting its use for deep corneal or intraocular fungal infections in equine ophthalmology may be limited.     

The use of mitomycin C as an adjunctive treatment for equine ocular squamous cell carcinoma

OBJECTIVE: To assess the effectiveness of topical mitomycin C application as an alternative adjunctive therapy to CO2 laser ablation in the treatment of equine ocular squamous cell carcinoma. DESIGN: A retrospective clinical study of eight client owned horses in which 10 affected eyes were treated for ocular squamous cell carcinoma over a 17 month period. (March 2003 to August 2004). PROCEDURE: Each horse was given a general anaesthetic to allow CO2 laser ablation of the lesion(s). Mitomycin C at a concentration of 0.4 mg/mL was then applied intraoperatively to the affected areas for 1 or 5 minutes. Postoperatively a triple antibiotic eye ointment was applied to the eye twice daily and each horse was treated with systemic non-steroidal anti-inflammatory drugs for 7 days. RESULTS: Recurrence following treatment was noted in three eyes. Two of these were retreated and no further signs developed. The remaining eye was enucleated at the request of the owner. Overall 90% of treated eyes appeared free of tumour a minimum of 11 months post treatment. CONCLUSION: In this case series mitomycin C appeared to offer a valid alternative to other adjunctive therapies currently employed in the treatment of equine ocular squamous cell carcinoma.     

Equine glaucoma: a retrospective study of 13 cases presented at the Western College of Veterinary Medicine from 1992 to 1999

The prevalence of equine glaucoma seen by the ophthalmology service at the Western College of Veterinary Medicine (WCVM) was 6.5%. The majority of cases (11/13) were associated with clinical manifestations of uveitis. Congenital glaucoma was documented in 1 case, and primary glaucoma was diagnosed in a 12-year-old quarter horse. There were no breed or sex predilections evident. Affected horses were middle-aged to old (average age = 9.5 years, ranging from 2 weeks to 23 years). The clinical manifestations of equine glaucoma included blindness, diffuse corneal edema, corneal vascularization, buphthalmia, corneal striae, recurrent secondary ulcerative keratitis, and less commonly, iris bombé, tapetal hyper-reflectivity, complete pupillary occlusion from posterior synechiae, and optic disc cupping. Elevated intraocular pressure confirmed the diagnosis (n = 10), while 3 cases were normotensive with signs of glaucoma including corneal striae and buphthalmia. Affected eyes were treated medically and/or surgically. Regardless of the therapy instituted, the visual outcome was poor. Most affected eyes were blind at presentation or became blind within a few weeks.     

The effect of topical administration of atropine sulfate on the normal equine pupil: influence of age, breed and gender

Objectives The purpose of this study was to determine the influence of age, breed and gender on vertical pupil diameter (VPD) following a single dose of 1% atropine sulfate ophthalmic solution in the normal equine eye. Animals studied Thirty‐two horses of various ages, breeds and genders were included. The horses had no history or clinical signs of ophthalmic disease. All horses studied had darkly pigmented irides. Procedures Two milligrams of 1% atropine sulfate ophthalmic solution was topically administered as a single dose in the right eye of each horse on Day 0. The VPD (mm) was measured in both eyes using digital calipers prior to treatment and every 24 h after administration for 2 weeks (Days 1–14). Duration of effect on VPD was then calculated for treated and untreated eyes. Data were also analyzed for effect of age, breed and gender on mean VPD, maximum VPD and time to maximum VPD. Results The VPD in the treated eye was significantly elevated compared to baseline measurements and compared to the untreated eye at all time points. Arabians had a greater mean VPD at Day 0 and on several days following treatment. Females had greater mean VPD compared to males on 5 out of 15 days. Conclusions Duration of mydriasis after administration of 1% atropine sulfate ophthalmic solution in the normal equine eye is greater than 14 days. Horses of the Arabian breed and female horses may be more sensitive to effects of cholinergic blockade in the eye.     

Unilateral optic nerve hypoplasia and hydrocephalus in a Pekingese

A 3-year-old, castrated male Pekingese was examined 2 days after automobile-induced trauma. Multiple pelvic injuries and visual deficits in the right eye were identified. During a subsequent postmortem examination, multiple pelvic fractures were confirmed; however, there was no evidence of head injury. Both globes were bilaterally symmetrical and grossly normal. The intraorbital and intracranial portions of the right optic nerve were threadlike and rudimentary in appearance, while the left optic nerve was grossly normal. Moderate dilatation of the left lateral ventricle was noted. Microscopically the right optic nerve and left nerve tract contained few identifiable nerve fibers. The right optic disc was depressed, and there was thinning of the optic nerve fiber and ganglion cell layers of the retina. No microscopic abnormalities were evident in the left optic nerve, optic disc, retina and right optic tract. The histologic changes in the right eye are consistent with optic nerve hypoplasia. The relationship between the optic nerve/optic tract lesions and the hydrocephalus is unknown.     

Topography of ganglion cells in the retina of the duck (Anas platyrhynchos var. domesticus)

The purpose of this study was to define ganglion cell density, size and topography in the retina of the mallard duck. After killing adult mallard ducks (Anas platyrhynchos var. domesticus), their eyes were removed using pentobarbital (30 mg/kg). The retinas were isolated, whole mount specimens were prepared by staining with 0.1% cresyl violet and then fixing the tissues for study. The retinal ganglion cells were counted, mapped and measured. The mean total number of ganglion cells was estimated at approximately 1.7 × 10⁶ and the retinal area centralis had the highest ganglion cell density with 15 820 cells/mm². The number of ganglion cell bodies was highest in the temporal area, followed by the nasal, dorsal and ventral areas. Ganglion cell size ranged from 56 to 406 μm². A population of small ganglion cells persisted into the central area just above the optic disc and the largest soma area was in the ventral zone of the retina. This localization of ganglion cells suggests that the quality of vision is not equal in all the areas of the duck retina and the central part may have the highest vision quality as a function of the retinal ganglion cells.     

Halicephalobus gingivalis (H. deletrix) infection in two horses in southern California.

Two horses, a 16-year-old male Holsteiner and a 5-year-old male miniature horse, were diagnosed with halicephalobiasis at the California Veterinary Diagnostic Laboratory System, San Bernardino Branch, in April and June of 1998. Over a period of 4 weeks, the Holsteiner horse developed renal dysfunction, blepharospasm, and blindness in the right eye. A 15-cm-diameter mass was detected on ultrasound examination in the right kidney. Terminally, the animal developed seizures and was euthanized. The miniature horse had a 6-week-long illness characterized by testicular enlargement and uveitis. This animal developed ataxia and died. Necropsy examination revealed bilateral enlargement of the kidneys in both horses, petechial hemorrhages of the optic nerve (Holsteiner), and a diffusely firm and enlarged left testicle (miniature horse). Microscopic evaluation of tissues revealed granulomatous nephritis, optic neuritis, retinitis, and encephalitis in both horses and orchitis in only the miniature horse with intralesional rhabditiform nematodes. Halicephalobus gingivalis was found in the urine sediment of both animals and in semen of the Holsteiner horse.     

Equine travellers to the Olympic Games in Hong Kong 2008: a review of worldwide challenges to equine health, with particular reference to vector-borne diseases

The past 10-20 years have seen exponential growth in the volume of trade in horses and equine germplasm; and the extent of global horse movements has increased significantly in the last 4 years. In preparing for the transport of elite Olympic horses to Hong Kong in 2008, it will be very important to be as fully informed as possible of the disease situation in both the exporting and importing country, import and re-entry requirements, as well as having a vaccination strategy to protect against particular diseases. In this context the review describes the equine vector-borne disease situation in Europe, Asia, Africa and South America and provides estimates of the number of horse movements between these countries, as well as information on import requirements and vaccination strategies.     

A promising surgical approach to equine glaucoma

The preceding case report by Wilson et al. (2015) describes the surgical placement of a Baerveldt glaucoma shunt in a glaucomatous equine eye that had been refractory to aggressive medical and repeated surgical therapies yet maintained functional vision. Shunt placement surgery successfully maintained vision and intraocular pressure in the normal range in the affected eye. This is the first report of long‐term successful glaucoma filtration surgery in a horse. Glaucoma shunt placement shows promise for maintaining vision and comfort in equine eyes affected with glaucoma. There is much to be learned in terms of the most appropriate implant type for the equine eye, the risk of complications such as ocular hypotony or tube fibrosis, and the utility of combination therapy with transcleral cyclophotocoagulation and implant placement, but with the report of one case in which gonioimplant placement has been associated with intraocular pressure control for over one year, further investigations appear warranted. This case provides a glimmer of hope for long‐term treatment of a painful, blinding disease that has traditionally carried a poor prognosis in horses.     

Endothelial cells and angiogenesis in the horse in health and disease—A review

The cardiovascular system is the first functional organ in the embryo, and its blood vessels form a widespread conductive network within the organism. Blood vessels develop de novo, by the differentiation of endothelial progenitor cells (vasculogenesis) or by angiogenesis, which is the formation of new blood vessels from existing ones. This review presents an overview of the current knowledge on physiological and pathological angiogenesis in the horse including studies on equine endothelial cells. Principal study fields in equine angiogenesis research were identified: equine endothelial progenitor cells; equine endothelial cells and angiogenesis (heterogeneity, markers and assessment); endothelial regulatory molecules in equine angiogenesis; angiogenesis research in equine reproduction (ovary, uterus, placenta and conceptus, testis); angiogenesis research in pathological conditions (tumours, ocular pathologies, equine wound healing, musculoskeletal system and laminitis). The review also includes a table that summarizes in vitro studies on equine endothelial cells, either describing the isolation procedure or using previously isolated endothelial cells. A particular challenge of the review was that results published are fragmentary and sometimes even contradictory, raising more questions than they answer. In conclusion, angiogenesis is a major factor in several diseases frequently occurring in horses, but relatively few studies focus on angiogenesis in the horse. The challenge for the future is therefore to continue exploring new therapeutic angiogenesis strategies for horses to fill in the missing pieces of the puzzle.     

Expression of a 4-(hydroxy-3-nitro-phenyl) acetyl (NP) specific equi-murine IgE antibody that mediates histamine release in vitro and a type I skin reaction in vivo

Due to characteristic clinical signs, immunoglobulins of isotype E (IgE) are believed to be involved in several allergic diseases of the horse. To date, closer investigations have been hampered by the fact that neither purified equine IgE nor anti-equine IgE monoclonal antibodies were available for IgE isotype determination. As an approach to solve this problem, we constructed a stable cell line (EqE6) that expresses recombinant equi-murine IgE specific for 4-(hydroxy-3-nitro-phenyl) acetyl (NP). Biochemical analysis of the purified protein revealed a highly glycosilated IgE monomer of approximately 230,000 Da. The biological ability of the NP-IgE to mediate histamine release after crosslinking with antigen was demonstrated in vitro using equine blood leucocytes. In vivo, the intradermal application of NP-IgE followed by antigen crosslinking induced a type I hypersensitivity skin reaction in horses. Both results indicate that the recombinant NP-IgE contains an intact and functional Fc(epsilon) RI binding site and mediates effector functions in equine basophils and cutaneous mast cells. This equi-murine IgE can be used for the production of IgE-specific polyclonal and monoclonal antibodies. In addition, the NP specificity allows the antigen-specific activation of equine Fc(epsilon)-receptor-expressing cells, such as mast cells and basophils. This property could be used to investigate IgE-mediated mechanisms for a better understanding of equine type I allergic diseases.     

Equine cervical intervertebral disc degeneration is associated with location and MRI features

Morphology of the equine cervical intervertebral disc is different from that in humans and small companion animals and published imaging data are scarcely available. The objectives of this exploratory, methods comparison study were (a) to describe MRI features of macroscopically nondegenerated and degenerated intervertebral discs (b) to test associations between spinal location and macroscopic degeneration or MRI‐detected annular protrusion and between MRI‐detected annular protrusion and macroscopic degeneration, and (c) to define MRI sequences for characterizing equine cervical intervertebral disc degeneration. Ex vivo MRI of intervertebral discs was performed in 11 horses with clinical signs related to the cervical region prior to macroscopic assessment. Mixed‐effect logistic regression modeling included spinal location, MRI‐detected annular protrusion, and presence of macroscopic degeneration with “horse” as random effect. Odds ratio and 95% confidence interval were determined. Reduced signal intensity in proton density turbo SE represented intervertebral disc degeneration. Signal voids due to presence of gas and/or hemorrhage were seen in gradient echo sequences. Presence of macroscopic intervertebral disc degeneration was significantly associated with spinal location with odds being higher in the caudal (C5 to T1) versus cranial (C2 to C5) part of the cervical vertebral column. Intervertebral discs with MRI‐detected annular protrusion grades 2‐4 did have higher odds than with grade 1 to have macroscopic degeneration. It was concluded that MRI findings corresponded well with gross macroscopic data. Magnetic resonance imaging of the equine cervical intervertebral disc seems to be a promising technique, but its potential clinical value for live horses needs to be explored further in a larger and more diverse population of horses.     

Computed tomographic dimensions of the normal adult equine eye

There are limited data on whether the dimensions of the equine eye and its internal structures change with bodyweight in horses. The aim of this study was to identify whether the size of the equine eye and its individual structures varied in a predictable manner with bodyweight, and to examine the reliability of computed tomography (CT) scans in the measurement of the equine eye. Ninety horses which had undergone CT examination of the head for non‐ocular disease were included. All measurements of the eye were performed twice on all eyes by the same operator to quantify intra‐operator agreement, and in 10 cases were also performed by a second operator to quantify inter‐operator agreement. Agreement was excellent for all but the rostrocaudal measurement of the anterior chamber, which was fair. The following variables correlated significantly with bodyweight: anterior‐posterior size of the globe (correlation coefficient: 0.586) and posterior segment (correlation coefficient: 0.554); the latero‐medial size of the globe (correlation coefficient: 0.452), anterior chamber (correlation coefficient: 0.504) and posterior segment (correlation coefficient: 0.455); and the orbital fossa diameter (correlation coefficient: 0.219). The lens size and anterior‐posterior distance of the anterior chamber did not correlate significantly with bodyweight. These results suggest that overall eye size and the size of the orbital fossa change with the bodyweight of the horse, but lens size remains consistent, and that CT measurements of the internal structures of the eye are repeatable and reproducible. This information aids in interventional procedures for ocular pathology and assessment of normal anatomy.     

Use of a hydroxyapatite orbital implant in a cosmetic corneoscleral prosthesis after enucleation in a horse

A hydroxyapatite orbital implant was used after enucleation of an eye from a 5-year-old performance horse. A custom-made corneoscleral prosthesis was made and fitted over the hydroxyapatite implant. The implant and surgery were well tolerated. Placement of a cosmetic prosthesis is desired after enucleation of equine eyes to allow horses to return to competition. Synthetic spheres consisting of methylmethacrylate or silicone have been used, although reported complications have included extrusion, infection, and poor cosmetic results. Hydroxyapatite orbital implants made from marine coral allow vascular and fibrous tissue growth from the host orbit into the implant, which decreases the possibility of implant extrusion or infection and allows enhanced healing of defects in the overlying conjunctiva. Extraocular muscle fixation onto the implant permits motility and assists in the prevention of implant extrusion.