Results of 654 trans-pars plana vitrectomies of equine eyes with recurrent uveitis – follow-up until 18 years after surgery

Wollanke, B; Gerhards, H; Schinagl, Christine

doi:10.21836/pem20210301

Cited by 7 publications

(53 citation statements)

References 48 publications

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“…In European horses without a leopard coat pattern, the most effective method to prevent further episodes of uveitis and thereby preserve vision is vitrectomy [10,[18][19][20][21]. After a properly performed vitrectomy, which has been routinely performed for more than 30 years in horses with ERU, the control of inflammation is seen in 90-97% of horses [10,13,[21][22][23][24]. By contrast, uveitis in horses with a leopard coat pattern manifests differently.…”

Section: Introductionmentioning

confidence: 99%

“…Many of these studies have suggested an association between leptospiral infection and ERU [26][27][28][29][30][31]. For example, anti-Leptospira antibodies are regularly detected in vitreous material obtained during vitrectomies [13,15,21,[32][33][34][35][36][37][38][39][40][41]. These antibodies are detected using the micro agglutination test (MAT), and various enzyme-linked immunosorbent assays (ELISA) [42,43].…”

Section: Introductionmentioning

confidence: 99%

“…In other studies, Leptospira spp. are cultured and anti-Leptospira antibodies are detected in the same vitreous samples [13,21,32,35,39,[44][45][46]. In addition, lipL32 gene or 16S-rRNA are detected by a polymerase chain reaction (PCR) in up to 70% of intraocular samples collected from affected horses [32,39,[43][44][45].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to direct evidence of the leptospiral infection of vitreous samples from eyes affected with ERU, evidence of autoimmunity also exists [49]. However, Prof. Deeg's research group [50] performed all investigations using vitreous samples, from which leptospiral infections were also regularly detected [13,21,39,[41][42][43]46]. Furthermore, while vitrectomy removes the vitreous material, potential autoantigens from other tissues -especially the lens and retina-remain in the eye [18,39] which contradicts the idea of autoimmunity [39,51].…”

Section: Introductionmentioning

confidence: 99%

“…Taken together, data from numerous studies using specimens from eyes affected with ERU support the hypothesis that ERU is triggered and perpetuated by the chronic infection of the vitreous cavity with Leptospira spp., and that this may be eliminated by vitrectomy [13,21,32,33,36,37,39,44]. However, systemic antibiotic therapy has not been successful at controlling the inflammation seen in ERU.…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

et al. 2021

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Equine recurrent uveitis (ERU) causes painful inflammatory attacks and oftentimes blindness in the affected eyes. The disease is considered a late sequela of systemic leptospirosis. The most effective therapy is the surgical removal of the vitreous (vitrectomy), which is not only therapeutic, but provides vitreous material that can be assessed diagnostically. For example, the lipL32 gene, culturable Leptospira spp., and anti-Leptospira antibodies have all been detected in vitreous samples obtained from eyes with chronic ERU. Despite this clear evidence of leptospiral involvement, the systemic administration of antibiotics in infected horses is ineffective at resolving ERU. This syndrome of chronic recurrent inflammation, which is unresponsive to antibiotic therapy, combined with apparent bacteria evading the immune response, is consistent with a biofilm-associated infection. The purpose of this study, therefore, was to detect the in vivo biofilm formation of Leptospira spp. in vitreous samples collected during vitrectomy and examined using a Warthin-Starry silver stain and immunohistochemistry. All known steps of biofilm formation were visualized in these samples, including individual Leptospira spp., leptospiral microcolonies and dense roundish accumulations of Leptospira spp. In many instances spirochetes were surrounded by an extracellular substance. Taken together, data from the present study show that ERU is a biofilm-associated intraocular leptospiral infection, which best explains the typical clinical course.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

et al. 2021

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Effect of gentamicin on CD3+ T‐lymphocyte proliferation for treatment of equine recurrent uveitis: An in vitro study

Smith

Berglund

Robertson

et al. 2023

Veterinary Ophthalmology

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Objective The objective of the study was to determine the effect of gentamicin on CD3+ T‐lymphocyte proliferation and cell viability using an in vitro cell culture model as a means of investigating the mechanism of action of low‐dose intravitreal gentamicin injection. Animals Studied Three adult horses with no evidence of ophthalmic or systemic disease. Procedure Peripheral blood lymphocytes were treated with gentamicin at concentrations 37.5 μg/mL, 112.5 μg/mL, 187 μg/mL, 375 μg/mL, or 750 μg/mL then stimulated to proliferate with concanavalin A (ConA). 4′,6‐diamidino‐2‐phenylindole (DAPI) and carboxyfluoroscein succinimidyl ester (CSFE) were used as markers of cell viability and cell proliferation, respectively. Following 5‐day culture, live cell counts and CSFE fluorescent intensity data were collected via automated cell count and flow cytometry. The experimental design was duplicated using preservative‐free gentamicin and a proprietary brand formulation. Statistical analysis was performed using two‐way ANOVA with Tukey's multiple comparison test. Results No statistically significant comparisons in CD3+ T‐lymphocyte live cell counts and geometric mean fluorescent intensity of CSFE were identified between gentamicin concentrations or formulations. Conclusions Gentamicin had no effect on equine peripheral blood CD3+ T‐lymphocyte cell viability and proliferation in concentrations ranging from “safe” to “retinotoxic” in relation to intravitreal injection volumes. Low‐dose intravitreal gentamicin may not suppress the Th1‐ and Th17‐mediated immune response.

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Phacoemulsification Combined with Pars Plana Vitrectomy: Outcome in Horses with Acquired Cataracts Associated with Uveitis

Kalinovskiy,

Leser,

Ehrle

et al. 2024

Animals

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Background: Cataracts resulting from equine recurrent uveitis (ERU) or other forms of uveitis are usually associated with rapid progression. ERU is the most common ocular disease cause of blindness and cause of cataracts in horses. The necessity for the posterior capsulorhexis (PC) during phacoemulsification (PE) is controversial. This study aimed to evaluate vision and complications after PE combined with pars plana vitrectomy (PPV) in horses with uveitis-associated cataracts and compare the PE technique with and without posterior capsulorhexis. Methods: Thirty-two eyes of 28 horses with uveitis-associated cataracts aged 14 months to 19.6 years were treated with PE-PPV under identical conditions. Twenty-three eyes of 21 horses were affected by an ERU-associated (ERU group), and nine eyes of 7 horses were affected by cataracts related to uveitis with pathogenesis different to ERU (non-ERU group). PE-PPV was performed in 12 eyes of 10 horses (PC group) and 20 eyes of 18 horses without posterior capsulorhexis (NPC group). Follow-up examination was performed at a mean of 1.7 ± 1.8 years postoperatively (range: 1 month–6.4 years). Results: In the period up to 1 month postoperatively, 17/20 (85%) NPC-eyes and 8/12 (67%) PC-eyes (total: 25/32 [78%]) were visual. From 1–6 months postoperatively, 16/20 (80%) NPC-eyes and 7/12 (58.3%) PC-eyes (total: 23/32 [72%]), and from 6–12 months, 7/11 (63.6%) NPC-eyes and 3/8 (37.5%) PC-eyes (total: 10/19 [52.6%]) were visual. From 12–18 months postoperatively, 3/7 (42.9%) NPC-eyes and 2/9 (22.2%) PC-eyes (total: 5/16 [31.3%]), and from 18–24 months, 3/8 (37.5%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 4/16 [25%]) were visual. After 24 months postoperatively, 2/7 (28.6%) NPC-eyes and 1/8 (12.5%) PC-eyes (total: 3/15 [20%]) were visual. Despite the higher number of visual eyes in the NPC group at each time point, differences were not significant. No obvious differences regarding postsurgical vision were observed between the ERU- and non-ERU groups at each time point. In the overall population, a significant decrease in the number of eyes with postoperative active uveitis was observed during the follow-up examinations (p < 0.001). A significant increase in the number of eyes that were blind due to retinal detachment was observed in the overall patient population as the examination period progressed (p < 0.001). Retinal detachment was the sole long-term cause of blindness. Conclusions: In horses diagnosed with uveitis-associated cataracts and treated with PE-PPV, no persistent active uveitis was observed in the present study during follow-up examinations. However, the proportion of eyes that were blind due to retinal detachment increased. Whilst PE-PPV may prevent postsurgical persistent active uveitis and remove lens opacity, the prognosis for a visual outcome is guarded. A superior outcome in postsurgical vision was observed in the NPC group. However, caution is required when interpreting these results due to several factors that affect the independent comparison of the surgical groups.

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Results of 654 trans-pars plana vitrectomies of equine eyes with recurrent uveitis – follow-up until 18 years after surgery

Abstract: Results of 654 trans-pars plana vitrectomies of equine eyes with recurrent uveitis

Cited by 7 publications

References 48 publications

In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

Effect of gentamicin on CD3+ T‐lymphocyte proliferation for treatment of equine recurrent uveitis: An in vitro study

Phacoemulsification Combined with Pars Plana Vitrectomy: Outcome in Horses with Acquired Cataracts Associated with Uveitis

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