Long-term prospective assessment of subconjunctival triamcinolone acetonide in addition to topical therapy in the management of chronic superficial keratitis

Abstract

Chronic superficial keratitis (CSK) is a progressive inflammatory disease in adult dogs, associated with corneal vascular proliferation, edema and melanic pigment deposition. In the absence of a curative therapy, the current approach for the management of CSK aims to control disease progression and eventually decrease the severity of corneal lesions. Subconjunctival injections of corticosteroids may be effective in severe cases, where topical therapy alone is inadequate. The aim of this study was to comprehensively evaluate the effectiveness of subconjunctival triamcinolone acetonide (TA) injection in addition to topical steroid treatment for the long-term management of CSK, in dogs unresponsive to conventional topical steroids. Treatment efficacy was assessed in 11 dogs with bilateral CSK by periodic evaluation of the cornea in terms of vascularization, edema and pigmentation for up to 120 weeks. Clinically significant reductions in corneal pigmentation (P<0.0001), vascularization (P<0.0001) and edema scores (P<0.0001) were achieved during therapy. The greatest reduction was exhibited by corneal edema, closely followed by vascularization. Corneal pigmentation was less responsive and complete regression has not been achieved in any of the dogs. Severely affected corneas exhibited greater improvements in terms of pigmentation, whereas moderately affected corneas showed a slight decrease. Corneal edema and vascularization were adequately controlled, whereas corneal pigmentation exhibited a lower decrease in severity and was more difficult to manage on a long-term basis. This study suggests that subconjunctival injection of TA in addition to topical steroids could represent an effective option for long-term management of CSK in dogs unresponsive to topical steroids alone.

Novel Treatment of Chronic Superficial Keratitis in Dog – Case Report

“…Currently, there is no cure for CSK, and no standard treatment is yet determined (Bedford and Longstaffe 1979). Therapeutic success is considered as delay of progression which can be achieved by topical application of corticosteroids alone or in combination with cyclosporine but only in mild cases (Williams et al 1995;Maggs et al 2007;Beteg et al 2021;Zubrický and Trbolová 2022). In cases where immunosuppressive treatments are not effective, more invasive therapeutic approaches such as superficial keratectomy, radiotherapy (Allgoewer and Hoecht 2010), or cryosurgery (Holmberg et al 1986).…”

Hydrodissection to create conjunctival flaps in dogs with corneal ulcers

“…Galeno et al [21] created conjunctival flaps in normal dogs using a volume of 0.7 mL. The subconjunctival route involves the use of volumes similar to those described in this study, although for treating different conditions [32][33][34][35].…”