OBJECTIVE. UV-A/Riboflavin crosslinking of corneal collagen fibers (CXL) is a highly promising therapy for corneal melting in humans. A prospective interventional, non-randomized, controlled study was conducted to compare the stabilizing effect of CXL treatment on melting keratitis in dogs and cats and the complication rate of CXL to those of standardized intensive medical treatment. PROCEDURES. Forty-nine eyes with melting keratitis were included in the study between October 2009 and October 2012. All eyes were treated according to the same medical treatment protocol. Nineteen eyes were CXL-treated and 30 eyes were not. Follow-up included slit-lamp examination, fluorescein staining, ulcer size measurement, stromal stability evaluation, photographic documentation and documentation of complications. RESULTS. Five of 19 eyes in the CXL group and 9/30 eyes in the control group required rescue stabilization due to continued melting. Seven of the 9 control group corneas stabilized after rescue CXL treatment. At initial presentation, the ulcers in the canine CXL group were significantly deeper and larger than in the control group. Ulcer deepening during follow-up was more pronounced in the canine control group than in the canine CXL group. CXL treatment related complications were not observed. CONCLUSIONS. Based on the similar failure rates in the control and CXL treatment groups despite the poorer initial situation in the CXL group, the tendency for the ulcers in the control group to deepen and the stabilization of all corneas receiving CXL rescue treatment, we believe that CXL has its place as an adjunctive therapy for melting keratitis in veterinary ophthalmology. RESULTS.Five of 19 eyes in the CXL group and 9/30 eyes in the control group required 39 rescue stabilization due to continued melting. Seven of the 9 control group corneas stabilized 40 after rescue CXL treatment. At initial presentation, the ulcers in the canine CXL group were 41 significantly deeper and larger than in the control group. Ulcer deepening during follow-up 42 was more pronounced in the canine control group than in the canine CXL group. CXL 43 treatment related complications were not observed. 44 CONCLUSIONS. Based on the similar failure rates in the control and CXL treatment groups 45 despite the poorer initial situation in the CXL group, the tendency for the ulcers in the control 46 group to deepen and the stabilization of all corneas receiving CXL rescue treatment, we 47 believe that CXL has its place as an adjunctive therapy for melting keratitis in veterinary 48 ophthalmology. 49
Objective To evaluate the most common bacterial pathogens associated with septic keratitis in veterinary patients from Switzerland. The second objective was to analyze antibiotic susceptibility test results of the identified bacterial pathogens. The third objective was to evaluate potential breed predispositions to septic keratitis. Procedures Two hundred and fifty-five cultures and antibiotic susceptibility reports from dogs, cats, and horses with septic keratitis that were presented to the University of Zurich Veterinary Medical Teaching Hospital between 2009 and 2013 were reviewed. Odds ratios for the risk of having a septic keratitis were estimated for all dog and cat breeds compared to the general nonbrachycephalic hospital population. Results Ninety-six, 29, and 31 positive cultures were obtained from 89 canine, 28 feline, and 29 equine eyes, respectively. Repeat sampling accounted for the differences in numbers. Negative culture results were obtained in 50, 31, and 18 cases. Staphylococci and streptococci accounted for 66% of the isolates in dogs and 80% of the isolates in cats and horses. Staphylococcus spp. had a higher percentage of fluoroquinolone-resistant isolates compared to previous reports. Brachycephalic breeds had elevated odds ratios for the presence of septic keratitis. Conclusion Identified bacterial pathogens and their prevalence as well as the elevated odds ratios for septic keratitis in brachycephalics are roughly consistent with previous studies. Based on systemic breakpoint data, resistance to commonly used topical antibiotics, including the second-generation fluoroquinolones, was found.
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