ObjectiveTo retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland.Animals and proceduresMedical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed.ResultsForty‐seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes. Aspergillus flavus was the most frequent fungal isolate (9/17, 53%), followed by Cylindrocarpon sp. (3/17, 18%) and Aspergillus fumigatus (2/17, 12%). Susceptibility was tested for 10/11 Aspergillus sp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B. Cylindrocarpon sp. isolates were resistant to both agents. Streptococcus equi subsp. zooepidemicus was the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13 Streptococcus sp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty‐six of the eyes underwent globe‐sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively.ConclusionsAlthough Aspergillus sp. and S zooepidemicus were the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.
Glaucoma is an optic neuropathy and one of the leading causes of blindness. Its hereditary forms are classified into primary closed-angle (PCAG), primary open-angle (POAG) and primary congenital glaucoma (PCG). Although many loci have been mapped in human, only a few genes have been identified that are associated with the development of glaucoma and the genetic basis of the disease remains poorly understood. Glaucoma has also been described in many dog breeds, including Dandie Dinmont Terriers (DDT) in which it is a late-onset (>7 years) disease. We designed clinical and genetic studies to better define the clinical features of glaucoma in the DDT and to identify the genetic cause. Clinical diagnosis was based on ophthalmic examinations of the affected dogs and 18 additionally investigated unaffected DDTs. We collected DNA from over 400 DTTs and a genome wide association study was performed in a cohort of 23 affected and 23 controls, followed by a fine mapping, a replication study and candidate gene sequencing. The clinical study suggested that ocular abnormalities including abnormal iridocorneal angles and pectinate ligament dysplasia are common (50% and 72%, respectively) in the breed and the disease resembles human PCAG. The genetic study identified a novel 9.5 Mb locus on canine chromosome 8 including the 1.6 Mb best associated region (p = 1.63×10−10, OR = 32 for homozygosity). Mutation screening in five candidate genes did not reveal any causative variants. This study indicates that although ocular abnormalities are common in DDTs, the genetic risk for glaucoma is conferred by a novel locus on CFA8. The canine locus shares synteny to a region in human chromosome 14q, which harbors several loci associated with POAG and PCG. Our study reveals a new locus for canine glaucoma and ongoing molecular studies will likely help to understand the genetic etiology of the disease.
Objective To obtain a reference range for evaluation of intraocular pressure (IOP) in horses using Tonovet Plus®, to compare the IOP readings obtained with Tonovet® and Tonovet Plus®, and to evaluate the repeatability of readings. Animals studied and Procedures Intraocular pressure of 30 client‐owned horses (60 eyes) with no signs of illness or ocular disease was evaluated using Tonovet® and Tonovet Plus® rebound tonometers. Horses’ mean age was 10.7 (range 6‐17) years. Triplicate measurements were performed without using sedatives or local anesthetics, with minimal restraint. Results Calculated reference intervals (the CLSI robust method) were 14.4‐27.2 mmHg for Tonovet® and 16.0‐26.1 mmHg for Tonovet Plus®. Mean values (± standard deviation, SD [± coefficient of variation, CV]) obtained with Tonovet Plus® (21.6 ± 2.45 mmHg [11.3%]) were on average 0.6 mmHg higher than with Tonovet® (21.0 ± 3.14 mmHg [15.0%]), and a negligible statistical difference between the devices was found using the paired sample t test (P = .049). The correlation coefficient for the averaged triplicate measurements was 0.73. The average CV was 4.6% and 4.4% for Tonovet® and Tonovet Plus®, respectively. Conclusions The repeatability of measurements was very good with both devices. The readings between the two devices differed statistically significantly, but the correlation was considered good and the variation was numerically small, and thus, the difference was considered clinically irrelevant. When monitoring disease process or treatment response in an individual patient, repeated readings are best performed using a similar device to avoid false interpretation of results.
Background Midlife insulin resistance has been associated with an increased risk for cognitive decline (1) and amyloid accumulation (2). We hypothesized that midlife insulin resistance would predict amyloid accumulation 20 years later, and the change in brain amyloid accumulation during the 5‐year imaging follow‐up. Methods We studied 60 cognitively normal participants from the Finnish population‐based Health2000 study in 2014‐2016 with 11C‐PIB‐PET (2). They were recruited according to their homeostatic model assessment of insulin resistance (HOMA‐IR) values measured 15 years earlier in 2000, and their APOEε4 genotype. The insulin resistance group (IR+, HOMA‐IR <1.25) and the control group (IR−, HOMA‐IR > 2.17) both included 30 participants and 50% APOEε4 carriers. In 2019‐2021 43 participants took part in the 5‐year 11C‐PIB‐PET‐imaging follow‐up. Here, we report the change in amyloid accumulation in the IR+ group (n = 19, 57% APOE ε4 carriers) and the IR‐ group (n = 24, 46% APOEε4 carriers) during this 5‐year interval. 11C‐PIB‐PET images were analyzed with an in‐house pipeline and standard uptake value ratio (SUVR) composite scores were calculated. Kruskal‐Wallis test and the Steel‐Dwass method was used to analyze the difference in amyloid accumulation rates between groups, and Spearman’s correlation was utilized to assess the association between HOMA‐IR and amyloid accumulation. Result At the 20‐year follow‐up, amyloid accumulation was significantly higher in the IR+ group than the IR‐ group (composite SUVR 2.43 vs. 1.96, p = 0.03) (Fig. 1). The change in amyloid accumulation during 5 years was significantly higher in the IR+/APOEε4+ group than in either IR−/APOEε4− (mean change in composite SUVR 0.79 vs. 0.32, p = 0.02) or IR+/APOEε4− groups (mean change in composite SUVR 0.79 vs. 0.26, p = 0.046,) (Fig. 2). HOMA‐IR in 2000 (rS = 0.39, p = 0.01) and 2014‐2016 (rS = 0.34, p = 0.03), but not in 2019‐2021 (rS = 0.24, p = 0.13), correlated with 11C‐PIB composite SUVR at the 20‐year follow‐up. Conclusion These results suggest that IR could be an additive risk factor for late‐life amyloid accumulation in APOEε4 carriers, and that midlife, but not late‐life IR associates with amyloid accumulation. 1) Ekblad et al., Diabetes Care 2017 2) Ekblad et al., Neurology 2018
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