Equine deep stromal abscesses (51 cases – 2004–2009) – Part 2: the histopathology and immunohistochemical aspect with attention to the histopathologic diagnosis, vascular response, and infectious agents

Henriksen, Michala de Linde; Andersen, Pia Haubro; Mietelka, Kristy A.; Farina, Lisa L.; Thomsen, Preben D.; Plummer, Caryn E.; Mangan, Brendan G.; Heegaard, Steffen; Coleman, James; Toft, Nils; Brooks, Dennis

doi:10.1111/vop.12102

Cited by 15 publications

(6 citation statements)

References 36 publications

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“…In fungal deep stromal abscesses, the fungi produce more proteases to allow movement posteriorly within the stroma where they then attract neutrophils at the level of Descemet's membrane. The cellular infiltrate in fungal plaques is a neutrophilic, suppurative keratitis that is associated with fungi [2,3]. Macrophages and monocytes are rarely seen histologically in our fungal plaque cases.…”

Section: Discussionmentioning

confidence: 79%

“…Macrophages and monocytes are rarely seen histologically in our fungal plaque cases. This may be important to plaque formation, as there is a strong suggestion that the chemoattraction of macrophages instead of neutrophils would reduce the pathologic capabilities of fungi in horse keratopathies [1][2][3]. doi: 10.7243/2054-3425-3-2…”

Section: Discussionmentioning

confidence: 99%

“…Superficial keratectomies, debridement and, plaque scrapings were performed standing following sedation with xylazine 1 or detomidine 2 . A motor nerve block was then performed using 1% lidocaine 3 and tetracaine 4 was applied to provide topical anesthesia to the cornea. Loose pieces of the plaque were carefully removed with small scissors and placed in formalin.…”

Section: Methodsmentioning

confidence: 99%

“…A lack of integrity and stability of the precorneal tear film, and corneal epithelial cell injury predispose and encourage fungal adhesion, invasion and infection of the horse cornea. It may be that unique metabolic and immunologic characteristics of the horse tear film, the normal low resting temperature of the horse cornea, the large corneal surface area, and/or interspecies alterations in corneal immunoprotection make the horse cornea more susceptible than that of other animal species to keratomycosis [2,3]. It also seems likely that the role and activity of horse neutrophils versus that of horse macrophages in infiltrating and influence the healing process of the diseased horse cornea may predispose to fungal infection [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…They include tear film disruption [4], epithelial microerosions [4], ulcerations of variable stromal depths [1,[5][6][7][8][9], corneal dissolution and melting [5,9], corneal perforations and subsequent iris prolapse [10], stromal abscess [1,7,10,11], and stromal plaque formation [1,5,6,10]. It seems clear that tear film instability and disruption of corneal epithelial integrity are necessary for most forms of keratomycosis to occur in the horse [1][2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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The fungal plaque form of equine keratomycosis

Maxwell¹,

Plummer²,

Brooks³

2015

Vet Med Anim Sci

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Objective: To describe clinical findings and visual outcomes of the fungal plaque form of equine keratomycosis. Design: Retrospective medical records study. Animals studied: Medical records of horses with the fungal plaque form of keratomycosis that presented to the University of Florida Veterinary Medical Center from 2001 to 2013 were reviewed. Procedures: Data collected for all horses with corneal fungal plaques at the University of Florida Veterinary Medical Center from 2001 to 2013 included photographs at various points during treatment, and the signalment and clinical description of ocular lesions, medical and surgical treatments, diagnostic test results, and therapeutic outcomes from medical records. Diagnosis of the plaque form of keratomycosis was based on the clinical appearance in addition to cytology and/or histologic results. Results: Twenty-two horses with keratomycosis with fungal plaques were identified. Corneal scraping found septate hyphae in all 22 eyes. Thirteen eyes (59.1%) had positive fungal culture results from the plaque. Dematiaceous fungi (n=3), Fusarium and Scopulariopsis (n=3), Aspergillus sp (n=4) and unidentified fungi or molds (n=4) were cultured from fungal plaques. Thirty-two percent (n=7) of the eyes cultured had bacterial infections in addition to the fungal infection. Fungi alone were cultured in six eyes (27.3%). Bacteria only were cultured in 6 eyes (27.3%). Culture did not reveal positive bacterial or fungal presence in three (13.7%) plaques. Medical therapy was utilized in all twenty two horses. Ninety-one percent (n=20 horses) of the horses were treated with at least one topical antifungal and at least one topical antibiotic, while one horse was treated with only topical antifungals and one horse was treated with only topical antibiotics. Nine of the horses received one topical antifungal medication and twelve received a combination of two topical antifungal medications with natamycin and either miconazole or voriconazole being the most common combination. Topical antiproteases and mydriatic/cyloplegics, and systemic nonsteroidal anti-inflammatory drugs were used in all horses. Ninety-one percent (n=20 horses) received surgical intervention of some form with 68% (n=15 horses) receiving at least one standing keratectomy and 23% (n=5 horses) receiving a superficial keratectomy under general anesthesia. Mean time to resolution was 6.5±4.1 weeks. Following medical and surgical therapy, 73% (n=16) of the eyes were visual and 27% (n=6 horses) were enucleated. The mean time to resolution of horses in which vision was preserved was 7.5±3.6 weeks. Conclusions:The visual outcome of therapy of 22 horses with the dark fungal plaque form of keratomycosis was positive in 73%. Successful treatment of the fungal plaque form of keratomycosis was aided by plaque removal, usually hastened by performing one or more keratectomies, and concurrent successful management of corneal ulceration and accompanying uveitis.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%