Clinical, ultrasonographic, and histopathologic findings in seven horses with Descemet's membrane detachment: A case series

Abstract

ObjectiveTo describe ultrasonography as a diagnostic method of in vivo Descemet's membrane detachment (DMD) in horses. Animals studied: Seven horses (three Icelandic horses, two Dutch Warmblood horses, one Appaloosa, and one Welsh Pony), presenting with moderate‐to‐severe focal or diffuse corneal edema, in whom DMD was suspected on ultrasonographic examination and confirmed with histopathology, were studied.ProcedureA retrospective analysis of case records of horses with suspected DMD was performed.ResultsMedian age at presentation was 14 years (range 11‐24). Clinical signs in eyes with DMD were unilateral in all horses and included blepharospasm and epiphora (6/7), buphthalmos (5/7), moderate‐to‐severe focal or diffuse corneal edema (7/7), corneal epithelial bullae (4/7), corneal neovascularization (4/7), Haab's striae (2/7), corneal endothelial precipitates (1/7), fibrin in the anterior chamber (1/7), focal cataract (2/7), and pigment deposits on the anterior lens capsule (1/7). During transpalpebral ultrasonography, a distinct linear echogenic structure was noted in the anterior chamber, initially diverging from, and later running parallel to, the posterior lining of the cornea in all eyes studied. In all cases, the cornea was severely thickened and echogenic, consistent with edema, and DMD was suspected. In all horses, the clinical signs progressed and the affected eye was eventually enucleated. Histopathology revealed DMD (7/7), spindle cell proliferation (4/7), Descemet's membrane reformation (3/7), and inflammation of the anterior uvea (5/7). Overall incidence was 1.04%.ConclusionsUltrasonography is an adequate tool in diagnosing DMD in horses. Descemet's membrane detachment should be included in the differential diagnosis in horses with dense focal or diffuse corneal edema.

Acute corneal hydrops of presumed traumatic origin: An uncontrolled case series (three horses)

“…2017a; Slenter et al . 2020) were ruled out based on the history, comprehensive ophthalmic examination and response to therapy in each case.…”

“…2015; Slenter et al . 2020), although this imaging tool may not be sensitive enough to detect a focal Descemet’s membrane rupture. Attempts to confirm the suspicion of Descemet’s membrane rupture using optical coherence tomography or ultrasound biomicroscopy are suggested in future cases of equine acute corneal hydrops.…”

“…Third, other differentials for severe corneal oedema in horses (eg uveitis, glaucoma, endotheliitis, heterochromic iridocyclitis with secondary keratitis and corneal infection) (Pinto et al 2015;Brooks et al 2017a;Slenter et al 2020) were ruled out based on the history, comprehensive ophthalmic examination and response to therapy in each case.…”

“…Optical coherence tomography and ultrasound biomicroscopy are two imaging modalities used to detect Descemet's membrane rupture in humans, cats and horses (Grewal et al 2000; Matas Riera Schlesener et al 2018;Rodriguez Galarza and McMullen 2020); unfortunately, such imaging modalities were not available to the authors at the time of each case management. Conventional ocular ultrasound can be considered for cases with large Descemet's membrane separations in horses (Matas Riera et al 2015;Slenter et al 2020), although this imaging tool may not be sensitive enough to detect a focal Descemet's membrane rupture. Attempts to confirm the suspicion of Descemet's membrane rupture using optical coherence tomography or ultrasound biomicroscopy are suggested in future cases of equine acute corneal hydrops.…”

Newly Modified Descemetopexy Method in Descemet’s Membrane Detachment and Prognostic Analysis: A Systematic Review

“…When edema involves the pupillary area, vision will be affected. DMD as a rare, potentially sight-threatening complication may occurring after various intraocular surgeries [1] [2,3] [4] [5]. Cataract surgery is the most common, with a morbidity rate of approximately 0.044% per year [6] [6].…”