Superficial, nonhealing corneal ulcers in horses: 23 cases (1989-2003)

Objective To characterize superficial, nonhealing corneal ulcers in the horse and to assess the affect of age, breed, sex, inciting cause of the ulcer, and treatment on healing time of these ulcers. Design Retrospective study. Animals Twenty‐three horses with superficial, nonhealing corneal ulcerations. Procedure Medical records from 1989 to 2003 of horses diagnosed with superficial, nonhealing corneal ulcers were reviewed. Signalment, duration of clinical signs, ophthalmic abnormalities, treatment and response to treatment were recorded. Horses were treated, in addition to medical therapy, using debridement, debridement and grid keratotomy, superficial keratectomy, and superficial keratectomy with conjunctival graft placement. Results Mean age ± SD of horses was 13.7 ± 5.8 years. The mean time of presence of the corneal ulceration was 38.9 ± 21.3 days. Mean time to complete re‐epithelialization of the corneal ulcers after treatment was 20 ± 14.7 days. Horses treated with debridement alone, grid keratotomy and superficial keratectomy healed in a mean time of 15.3 ± 14.6 days, 16 ± 12.6 days, and 22.8 ± 6.7 days, respectively. Conclusions and clinical relevance Horses treated with a single debridement at initial evaluation healed in a significantly shorter time period than horses treated with grid keratotomy or superficial keratectomy. The latter two procedures may be beneficial in the treatment of nonhealing ulceration in horses, but the results of this study suggest that these procedures should only be performed following failure of the ulcer to heal after epithelial debridement.     

Carbon dioxide laser photoablation adjunctive therapy following superficial lamellar keratectomy and bulbar conjunctivectomy for the treatment of corneolimbal squamous cell carcinoma in horses: a review of 24 cases

Objective To determine the complications and nonrecurrence rates following superficial lamellar keratectomy, bulbar conjunctivectomy, and adjunctive carbon dioxide (CO₂) photoablation for corneolimbal squamous cell carcinoma (SCC) in the horse. Study design Retrospective study. Sample population Twenty‐four horses with corneolimbal SCC. Procedure Medical records of horses diagnosed with corneolimbal SCC that was surgically excised and where CO₂ photoablation was used as an adjunctive therapy from 2000 to 2007 were reviewed. Signalment, prior therapy, tumor location and size, complications, and recurrence of SCC were recorded. Results The Thoroughbred was the most commonly (25%) represented breed. Lesions were >10 mm in diameter in 70.8% of cases. Eight horses (33.3%) had neoplastic cells extending to the deep margin of the keratectomy. All horses were available for follow‐up for an average ± standard deviation of 40.7 ± 25 months. Four horses (16.7%) developed a recurrence of SCC. Three of these four horses underwent repeat keratectomy and CO₂ photoablation, one each, at 4 months, 1, and 2 years following the initial procedure. One horse underwent enucleation 8 months following the initial procedure. Conclusions and clinical relevance As an adjunctive therapy, CO₂ photoablation was successful in 87.5% of the horses following a single procedure and in a total of 91.7% following a second therapeutic application. CO₂ photoablation appears to be effective as an adjunctive therapy following removal of large corneolimbal SCC in the horse and in cases in which all tumor cells were not excised.     

Treatment of Advanced Squamous Cell Carcinomas Involving the Equine Cornea

Corneal squamous cell carcinomas with surface areas of more than 2.0 cm were diagnosed in 26 eyes of 25 horses. The depth of the lesion into the corneal stroma and involvement of the ocular adnexa were important determinants for surgical treatment. Corneal tumors that extended into adjacent palpebral conjunctiva, eyelid, or orbit were not amenable to complete excision, while those that involved only cornea and bulbar conjunctiva were treated surgically by keratectomy and beta radiation. Initial treatment was keratectomy followed by beta radiation on 24 eyes and enucleation of two eyes. Twenty keratectomy patients remained tumor free after long-term follow-up. One was lost to follow-up and three recurred. The recurrences were retreated with subsequent cure (one horse), enucleation (one horse), or euthanasia (one horse).     

Amniotic membrane transplantation for corneal surface reconstruction after excision of corneolimbal squamous cell carcinomas in nine horses

OBJECTIVE: The purpose of this study was to evaluate the usefulness and effectiveness of permanent amniotic membrane transplantation as an adjunctive treatment to superficial keratectomy alone or combined with strontium-90 irradiation for treatment of equine corneolimbal squamous cell carcinoma (SCC) to decrease corneal scarring and recurrence rate. STUDY: The retrospective case study included 11 horses (n = 12 eyes) diagnosed and treated for ocular SCC that involved the limbus and cornea. Nine of those horses (n = 9 eyes) were treated between 2002 and 2006, with superficial lamellar keratectomy alone or combined with strontium-90 irradiation and followed by placement of a permanent amniotic membrane graft in the surgical defect. The level of scarring (i.e. the clarity of the cornea) resulting with the use of amniotic membrane was subjectively compared to cases where a permanent bulbar conjunctival graft was performed following keratectomy combined with strontium-90 irradiation or cryotherapy (n = 3 eyes). Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe. RESULTS: The nine horses that received an amniotic membrane graft after keratectomy alone or combined with irradiation showed a minimal level of scarring in a cornea that regained a greater transparency in comparison to the horses that were treated with a bulbar conjunctival graft. All of the horses that received an amniotic membrane graft had 226 +/- 218 days of follow-up without tumor recurrence (mean +/- SD), ranging from 21 days to 778 days. CONCLUSIONS: The combination of superficial keratectomy alone or associated with beta-irradiation and permanent amniotic membrane transplantation is an effective treatment of corneal or corneolimbal SCC in horses. The placement of an amniotic membrane material represents an alternative surgical procedure to bulbar conjunctival grafts, especially if there is a lack of bulbar conjunctiva tissue available after tumor resection or if a particularly large corneal resection is necessary. The amniotic membrane is incorporated into the corneal defect and seems to create noticeably much less scarring than a corneal defect covered by bulbar conjunctiva.     

Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990-2002): 38 horses

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of postoperative beta-irradiation with strontium-90 as an adjunctive treatment to superficial keratectomy and permanent bulbar conjunctival graft for removal of equine corneolimbal squamous cell carcinoma (SCC), in decreasing recurrence rate. STUDY: The retrospective case study included 38 horses diagnosed and treated for SCC of the eye that involved the limbus and/or cornea. The patients were treated between 1990 and 2002, with strontium-90 irradiation immediately after corneal and conjunctival graft surgery. Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe that was previously treated. RESULTS: The Appaloosa was the most commonly represented breed and horses that had more than one base coat color represented the majority of the cases (53%). The coat colors of white, chestnut/sorrel and gray were the most commonly represented colors of the horses treated. Eight horses (21%) could not be assessed for tumor recurrence due to lack of two or more post-treatment examinations, and another horse was enucleated 6 days postoperatively due to progressive corneal ulceration. Twenty-four horses (63% of the entire study population; 83% of the followed cases) had a mean +/- SD of 1754 +/- 1319 days without tumor recurrence, ranging from 14 days to 5110 days. Five horses (13% of the entire study population; 17% of the assessed horses) had tumor recurrence at a mean +/- SD of 449 +/- 339 days with a range of 29 days to 900 days. For the five recurrences, treatment included local excision (n = 1), enucleation (n = 2), and additional strontium-90 therapy (n = 3). CONCLUSIONS: The combination of superficial keratectomy, beta-irradiation and permanent bulbar conjunctival grafts for limbal, corneal or corneolimbal SCC in horses is effective in at least 83% of the horses. Recurrence occurred in about 17% of the horses. Multiple biannual re-examinations are recommended to observe for tumor recurrence.     

Superficial stromal keratitis in the dog

Superficial stromal keratitis or pannus is a syndrome of corneal, conjunctival and third eyelid inflammation. Superficial stromal keratitis mainly presents as a subepithelial corneal infiltration of vascular connective tissue, and usually arises from the lateral (temporal) limbal area. In some dogs perilimbal hyperaemia and third eyelid blepharitis can be present without corneal involvement. The most commonly affected breed of dog is the German Shepherd. Most cases of superficial stromal keratitis can be controlled with topical corticosteroids, and only rarely is cryosurgery or superficial keratectomy required to remove excessive pigment and or granulation tissue. The precise aetiology of SSK is unknown, but is likely to be multifactorial, with sunlight being a significant factor. Corneal lipidosis and keratoconjunctivitis sicca can occur secondary to superficial stromal keratitis.     

Outcome of superficial keratectomy without conjunctival graft as a surgical technique for immune-mediated keratitis in horses: Four cases

This case report describes four horses with unilateral superficial or mid-stromal immune-mediated keratitis (IMMK) treated with a superficial keratectomy (SK) without a conjunctival graft. In two horses, the surgery was performed under general anaesthesia, and in two horses standing with sedation and local blocks. Results of this report show that SK is a viable treatment option in horses with chronic superficial and/or mid-stromal IMMK that can even be performed in the standing, sedated horse. When sufficient corneal tissue is removed, no recurrence is to be expected in the long-term follow-up (up to 31 months). In two horses, healing occurred without complications. Two horses developed a secondary bacterial infection post-operatively (Enterococcus faecalis and Staphylococcus aureus). In one case, this resulted in a pre-perforating melting corneal ulcer necessitating conjunctival pedicle graft surgery 13 days post keratectomy. In three horses, there was no recurrence of the IMMK with a long-term follow-up of 6–31 months. One case showed recurrence of IMMK in the cornea region surrounding the keratectomy 9 months after surgery.     

Semiconductor diode laser transscleral cyclophotocoagulation for the treatment of glaucoma in horses: a retrospective study of 42 eyes

Objective To evaluate the outcome of diode laser transscleral cyclophotocoagulation (TSCP) for the treatment of glaucoma in horses. Procedure Medical records at The Ohio State University were reviewed. All horses that underwent diode laser TSCP between the years of 1995 and 2007 were included. Preoperative, procedural and clinical follow‐up data were collected, and telephone follow‐up was performed. Results Forty‐two eyes of 36 horses were included. Twenty‐four hours prior to surgery mean intraocular pressure (IOP) was 37.17 ± 13.48 mmHg (42 eyes). Forty‐one of 42 eyes (98%) were sighted and 39 of 39 (100%) of eyes were receiving topical glaucoma medication. At 3–5 weeks postoperatively the average IOP was 19.36 ± 12.04 mmHg (22 eyes). IOP remained significantly lower than pretreatment values at all periods of clinical follow‐up (P < 0.05). There was no significant difference in vision outcome, or the requirement for topical glaucoma medication relative to pretreatment values at any follow‐up period. Hyphema in 5 of 42 eyes was the only complication noted. Of the 27 eyes seen for clinical follow‐up, 2 were enucleated because of refractory elevation of IOP. Mean telephone follow‐up was 49 months. Twenty‐one of 22 owners contacted (95%) reported that the treatment had been of value, 14 of 22 eyes (64%) were receiving topical glaucoma medication, and 13 of 22 eyes (59%) were considered sighted. Conclusions Diode laser TSCP aided in the control of IOP and maintenance of vision but did not eliminate the need for topical glaucoma medication during the period of clinical follow‐up.     

The effects of moxifloxacin ophthalmic solution 0.5% or gatifloxacin ophthalmic solution 0.3% treatment on corneal wound healing in pigmented rabbits following anterior keratectomy

Purpose These studies examined corneal healing rates, Type‐IV collagen and zonula occludens membrane‐associated protein (ZO‐1) expression, as well as aqueous PGE₂ and IL‐1β concentrations in pigmented rabbits treated with either moxifloxacin 0.5%, gatifloxacin 0.3% or BSS^® following anterior keratectomy. Methods Anterior keratectomy surgery was followed by topical administration with commercial ophthalmic formulations of either moxifloxacin or gatifloxacin or BSS^® (TID for 96 h). Images of the fluorescein‐stained healing corneas were analyzed for wound area. At 48 or 96 h following surgery, aqueous humor samples were collected and analyzed for the inflammatory mediators PGE₂ and IL‐1β using an ELISA. The corneas were subsequently evaluated using both scanning and transmission electron microscopy. In a second parallel study, corneas were evaluated at both 48 and 96 h for Type‐IV collagen and ZO‐1 expression using immunohistochemistry. Results Fluorescein‐stained corneal images at 96 h postsurgery demonstrated that 90% ± 8% re‐epithelialization for moxifloxacin, 81% ± 14% for gatifloxacin, and 88 ± 6% for BSS^® (P > 0.05). PGE₂ levels in the aqueous humor of fluoroquinolone treated eyes were reduced at 48 h compared to BSS^® treated eyes. IL‐1β was undetectable in all samples. No differences in Type‐IV collagen or ZO‐1 expression were observed between any treatment groups. There were no differences between groups in histological appearance or in ultrastructural healing processes. Conclusions These studies demonstrated that the commercial ophthalmic formulations of moxifloxacin and gatifloxacin were similar to each other in their effects on the levels of aqueous humor PGE₂ and rates of corneal wound re‐epithelialization.     

Ulcerative keratitis associated with qualitative tear film abnormalities in cats

Three cats with indolent corneal ulcers and one cat with bilateral corneal sequestration and normal aqueous tear production were found to have rapid tear break-up times (BUTs). Tear BUTs in clinically affected cats averaged 2.5 ± 1.29 s and 2.33 ± 0.58 s for the right and left eyes, respectively. Palpebral conjunctival biopsies were harvested from consistent sites from each eye of affected cats ( n  = 7 affected eyes), and age-and breed-matched controls ( n  = 2 unaffected eyes). Light microscopy revealed a marked decrease to complete absence of conjunctival goblet cells (average goblet cell (GC):epithelial cell (EC) density = 18:50), conjunctival epithelial dysplasia, squamous metaplasia, and neutrophilic and mononuclear cell submucosal infiltration in affected cats. Specimens from the control cats had an average GC:EC density of 34:50, and minimal submucosal inflammatory infiltrate. The corneas ( n  = 7 eyes) healed following surgical keratectomy with ( n  = 2 eyes) or without ( n  = 1 eye) conjunctival pedicle flaps, superficial keratectomy and striate keratotomy with ( n  = 2 eyes) or without ( n  = 2 eyes) third eyelid flaps, and mucinomimetic tear supplementation ( n  = 5 eyes). Goblet cell regeneration was confirmed after 5 months of mucinomimetic supplementation ( n  = 2 eyes). The etiology for these mucin deficiencies remains unknown.     

Comparison of gluteus medius muscle activity in Haflinger and Noriker horses with polysaccharide storage myopathy

Type 1 polysaccharide storage myopathy caused by genetic mutation in the glycogen synthase 1 gene is present in many breeds including the Noriker and Haflinger horses. In humans, EMG has already been used to document changes in the muscle activity patterns of patients affected by human glycogen storage disorders. Therefore, the aim of the present study was to describe gluteus muscle activity with surface electromyography (sEMG) in Haflinger and Noriker horses with known GYS1 mutation status during walk and trot. Thirty-two horses (11 Haflinger and 21 Noriker horses) with homozygous non-affected (GG), heterozygous affected (GA) and homozygous affected (AA) status of GYS1 mutation without overt clinical signs of any myopathy were selected for the current study. Using surface electromyography gluteus medius muscle activity at walk and at trot was measured, and muscle activity was described in relation to the maximum observed value at the same sensor and the same gait. In order to further describe the signals in detail comprising both frequencies and amplitudes, the crossings through the baseline and the 25, 50 and 75 percentile lines were determined. The result of the relative muscle activity did not show a consistent difference between affected and non-affected horses. Genetically affected (GA and AA) horses showed significantly less density of muscle activity for both gaits and horse breeds except for the crossings per second at the baseline and 75 percentile at walk in the Haflinger horses and 75 percentile at trot in the Noriker horses. The medians of all calculated density values were significantly lower in the GA Haflingers compared to the GG Haflingers (p = 0.012) and also in the AA Norikers compared to the GG Norikers (p = 0.011). Results indicate that the GYS1 mutation reduces the number of functional muscle fibres detected by sEMG measurements even in the absence of overt clinical signs.     

A matched observational study of canine survival with primary intraocular melanocytic neoplasia

A retrospective histopathologic study was performed to evaluate the effect of primary intraocular melanocytic neoplasia on canine survival. Tumor size, location within the globe, extent of infiltration, and mitotic index were analyzed for their potential to predict survival. A total of 244 cases of dogs with melanocytic tumors submitted to the Comparative Ocular Pathology Laboratory of Wisconsin from 1988 to 1998 were evaluated. Histopathologic criteria (mitotic index, cytologic features of anaplasia) were used to differentiate 188 benign melanocytomas from 56 malignant melanomas. Signalment evaluation of age, sex, and breed revealed similarities in both tumor populations, with the majority of tumors discovered in 9-year-old, female/spayed, mixed-breed dogs. A greater percentage of left eyes (66%) vs. right eyes (47%) was found in the melanoma population, but an equal distribution was found in the melanocytoma population (48% and 52%, respectively). The majority of tumors arose from the anterior uveal tract (79% in the melanocytoma and 95% in the malignant melanoma populations). The German Shepherd breed was predisposed in the limbal distribution. At the time of enucleation, most tumors had invaded the sclera, but did not show extrascleral extension (51% in the melanocytoma and 61% in the malignant melanoma populations). Survival analysis showed a significant difference in survival between control and malignant melanoma populations ( P  = 0.0081) and was suggestive of a difference between the melanocytoma and melanoma populations ( P  = 0.031). Tumor extension, tumor size, and mitotic index were not found to be reliable predictors of survival.     

Carbon Dioxide Laser Keratectomy as a Treatment Option for Equine Corneal Stromal Abscessation: A Comparison to Lamellar Keratectomy and Penetrating Keratoplasty

Carbon dioxide (CO₂) laser keratectomy was compared to lamellar keratectomy (LK) and penetrating keratoplasty (PK) as a potential treatment option for equine corneal stromal abscessation. The medical records of 35 client owned horses undergoing surgical management of stromal abscessation were reviewed. Among those 17 underwent LK, 3 PK and 15 CO₂ laser keratectomy. Healing of the stromal abscess was achieved in all treated eyes. Those horses undergoing CO₂ laser keratectomy demonstrated few complications, and the time to healing and cosmetic outcome was comparable to those horses undergoing LK and PK.     

Long‐term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis

Objective To determine the long‐term efficacy, complications, and duration of effect of a cyclosporine (CsA) suprachoroidal implant (CSI) in horses with equine recurrent uveitis (ERU). Methods Horses with ERU were treated with a 6‐mm diameter, 25 mg, reservoir matrix CsA implant in the deep sclera adjacent to the suprachoroidal space. Horses with follow‐up >1 year were examined for frequency of uveitis episodes, complications, and vision at last recheck. Results Data from 151 eyes of 133 horses from the USA and Europe that had CsA devices implanted for ERU were reviewed. Follow‐up time ranged from 13 to 85 months after surgery, with a mean and median follow‐up time of 28.9 and 26.3 months, respectively. Overall, at last follow‐up 78.8% of eyes were considered visual and the overall mean frequency of uveitis episodes after CSI was 0.09 ± SD 0.08 episodes per month. The most common complications leading to vision loss at last follow‐up were persistent uveitis episodes (54%), glaucoma (22%), mature cataracts (16%), and retinal detachment (6%). Persistent uveitis episodes tended to be the highest cause of vision loss in horses with <24 months and >48 months of follow‐up. Conclusions This study demonstrated the long‐term maintenance of vision of horses with ERU implanted with a CSI. The increased vision loss related to uveitis episode of inflammation in eyes after the likely depletion of CsA from the CSI suggests that a repeat CSI may be required at or before 48 months after surgery.     

Thermal cautery of the cornea for treatment of spontaneous chronic corneal epithelial defects in dogs and horses

A thermal cautery technique was used to treat spontaneous chronic corneal epithelial defects (SCCEDs) in 9 eyes of 8 dogs and 2 eyes of 2 horses. Animals were sedated, and a topical anesthetic was applied. A handheld thermal cautery unit was then used to make multiple, small (< or = 1 mm in diameter), superficial burns throughout the affected area. The cautery unit was applied just until the slightest degree of contraction of the collagen fibrils was observed. After the stromal bed of the defect was treated, a rim of epithelium that extended approximately 1 mm around the denuded stroma was also subjected to thermal cautery. Following surgery, a contact lens was placed in dogs but not in horses, and the eye was treated with broad-spectrum antimicrobial ophthalmic solutions. Defects in all 11 eyes healed with minimal scarring; mean time to healing in dogs was 2.1 weeks (range, 2 to 3 weeks). The defect healed in 1 week in 1 horse and in 2 weeks in the other. Many therapeutic options are available for the treatment of SCCEDs. Procedures such as epithelial debridement and anterior stromal puncture have been shown to have a high rate of success. In cases for which these less invasive procedures fail, our results suggest that thermal cautery may be a reasonable alternative to previously described treatments for SCCEDs in dogs and horses prior to more invasive procedures such as superficial keratectomy.     

Corneal squamous cell carcinoma in two dogs

Purpose To report two cases of corneal squamous cell carcinoma (SCC) in dogs. Methods Corneal tumors were resected by superficial keratectomy in two cases. Immunohistochemistry of the corneal tissues was performed using anti‐p53 antibody. Results The prominent features of the cases were a clinical history of pigmentary keratitis and chronic keratitis. In each case, a corneal mass was surgically removed with a superficial keratectomy and histologically diagnosed as corneal SCC. Both masses were negative for p53. To reduce chronic corneal irritation, 0.1% hyaluronate sodium ophthalmic solution was applied. After more than 15 months of postsurgical follow‐up there has been no recurrence of either neoplasm. Conclusion and discussion Chronic corneal irritation was suspected as the primary etiology for the corneal SCC. Appropriate surgical removal of the mass and subsequent conservative treatment for keratitis provided effective therapy in these two cases.     

Concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci

Objective To report concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci and to document any correlation with equine recurrent uveitis (ERU). Procedure Records of 131 horses (241 eyes) examined at the University of Georgia Veterinary Teaching hospital from 2001 to 2010 were reviewed with either clinically normal fundi or depigmented punctate chorioretinal foci in the absence of other fundic pathology. Data collected included patient signalment, concurrent clinical ocular findings and follow‐up information. Sex, presence of no other intraocular findings, presence of ERU, presence of cataracts, and presence of vitreal disease were compared between normal and foci groups using chi‐squared analysis. Age and length of follow‐up time were compared using a student’s t‐test. Results Ninety‐one horses (167 eyes) with chorioretinal foci and forty horses (74 eyes) with clinically normal ocular fundi were examined. Fifty‐eight (64%) horses with chorioretinal foci and 20 (50%) horses with clinically normal fundi had a normal intraocular examination. There was no significant difference in any of the criteria examined between groups. Conclusions Horses with depigmented punctate chorioretinal foci, in the absence of other fundic pathology, are not more likely to have intraocular disease or ERU than horses with clinically normal ocular fundi. These findings suggest that depigmented punctate fundic foci in horses are not indicative of or associated with ERU.     

Evaluation of tear film proteinases in horses with ulcerative keratitis

Ulcerative keratitis is a common and potentially blinding ocular disease of horses, capable of progressing to corneal perforation in as little as 24 h. This rapid stromal degeneration is mediated in part by exogenous and endogenous proteinases. We measured and compared the concentrations of two matrix metalloproteinases (MMP-2 and MMP-9) and a serine proteinase (neutrophil elastase) present in the precorneal tear film of normal horses and horses with rapidly progressing ulcerative keratitis. Precorneal tear film samples were collected from 23 ulcerated and 21 unaffected eyes of 23 horses with unilateral ulcerative keratitis, and from 33 normal eyes of 17 control horses. MMP-2, MMP-9, and neutrophil elastase were identified by casein and gelatin zymography and quantified by computerized image analysis. Median MMP-9 levels were significantly higher in the precorneal tear film of young control horses vs. older control horses ( P  = 0.005). Median MMP-2, MMP-9, and neutrophil elastase levels were significantly higher in the precorneal tear film of ulcerated eyes when compared to age-matched normal controls ( P  = 0.004, P  = 0.001, and P  = 0.012, respectively). Median MMP-2 levels were also significantly higher in the precorneal tear film of contralateral eyes of affected horses when compared to age-matched normal controls ( P  = 0.004). No significant differences in median proteinase levels were detected between 'sterile' ulcers and those from which bacteria or mixed infections (bacteria and fungi) were isolated. However, median MMP-2 and neutrophil elastase levels were significantly higher in the precorneal tear film of eyes with 'sterile' ulcers when compared with ulcerated eyes from which fungi were isolated ( P < 0.05). The results of this study support the use of topical antiproteinase therapy which targets both MMPs and serine proteinases in progressive equine ulcerative keratitis.     

Corneal esthesiometry in the healthy horse

Objective To determine corneal sensitivity in healthy adult horses in order to establish reference values. Animals studied One hundred eyes of 50 healthy adult horses. Procedure Corneal sensitivity was determined by evaluating the corneal touch threshold (CTT) in five different corneal regions using a Cochet‐Bonnet esthesiometer. Results Comparing CTT values (in mm filament length) of the five prescribed corneal regions revealed regional variations in corneal sensitivity, with the central region (21.15 ± 6.23 mm) being the most sensitive, followed by the nasal (20.75 ± 5.14 mm), temporal (20.70 ± 5.37 mm), ventral (20.15 ± 5.88 mm) and dorsal (15.85 ± 3.70 mm) region. However, differences between the central, nasal, temporal and ventral regions were not statistically significant, whereas the dorsal region was significantly (P < 0.0001) less sensitive compared to the other regions. Division of the horses into three age groups revealed an insignificant decrease in corneal sensitivity with age in the nasal, temporal, ventral and central region, and an insignificant increase with age in the dorsal region. Correlation of corneal sensitivity with age was statistically significant in the central, ventral and temporal region. No statistically significant difference in the CTT was found between left and right eyes and between males and females. Conclusions CTT values in 100 eyes of 50 healthy adult horses evaluated with a Cochet‐Bonnet esthesiometer generated reference values. Reference values are necessary to determine alterations of corneal sensation accompanying various eye diseases or systemic diseases.     

Amniotic membrane transplantation for the treatment of feline corneal sequestrum: pilot study

Objectives To describe and evaluate the use of equine amniotic membrane trans‐plantation after lamellar keratectomy for the treatment of corneal sequestrum in cats. Methods Six cats (seven eyes) of various breed and ages with corneal sequestra were treated surgically with lamellar keratectomy and amniotic membrane transplantation. All the sequestra and a small piece of the amniotic membranes used for each surgery were submitted for histopathologic examination. Results Five of the seven eyes showed minimal level of scarring in the cornea and good transparency. No recurrences of the sequestra have been noted during the follow‐up period (3–9 months). One eye had necrosis of the amniotic membrane 2 weeks after the surgery. The sequestrum of this eye showed a high level of bacterial contamination on histopathology. Three months later the same cat developed a descemetocele in the area where the necrotic amniotic membrane was rejected. A second eye developed a perforation under the amniotic membrane two weeks after the surgery. The sequestrum of this eye was deep and without vascularization. Conclusion Amniotic membrane transplantation after lamellar keratectomy was a valid procedure for surgical treatment of corneal sequestrum in cats. The procedure resulted in excellent cosmesis and functional vision in five of seven eyes; although case selection is important, particularly to exclude the very deep and non‐vascularized sequestra.