Equine ulcerative keratomycosis: visual outcome and ocular survival in 39 cases (1987-1996).
The medical records of 39 horses treated for ulcerative keratomycosis over a 10 year period were reviewed. Records were evaluated to determine the medical and/or surgical treatment protocol, visual outcome, globe survival and whether the outcome was influenced by the fungal species isolated. Stromal abscesses and iris prolapses caused by fungi were not included. Twenty of the horses underwent medical treatment only, and 19 horses had combined medical and surgical treatment. Most horses had been treated with topical antibiotics (n = 32) and atropine sulphate (n = 23) prior to referral; topical antifungals had been employed less frequently (n = 14). Fungi were identified by cytology (n = 31), culture (n = 33) and/or surgical histopathology (n = 6). Aspergillus (n = 13) and Fusarium (n = 10) were the most commonly isolated fungi. Miconazole (n = 35) was the most common topical antifungal medication utilised. Median duration of treatment was 48 days (range 31-192 days). Associated bacterial infection (n = 13) was frequently encountered. Visual outcome was favourable in 36/39 (92.3%) eyes. All eyes (20/20) retained vision following medical management only, and 16/19 (84%) retained vision following combined medical and surgical therapy. All medically treated horses (20/20), and 17/19 (89%) of those treated medically and surgically retained their globes. Overall ocular survival was favourable in 37/39 (94.9 %) eyes. Aggressive therapy can result in successful results for equine ulcerative keratomycosis.
Andrew
S E
SE
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610-0126, USA.
Brooks
D E
DE
Smith
P J
PJ
Gelatt
K N
KN
Chmielewski
N T
NT
Whittaker
C J
CJ
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001230:Aspergillus / Q000302:isolation & purification / Q000502:physiology; D003319:Corneal Stroma / Q000166:cytology / Q000382:microbiology; D003320:Corneal Ulcer / Q000382:microbiology / Q000628:therapy / Q000662:veterinary*; D015821:Eye Infections, Fungal / Q000382:microbiology / Q000628:therapy / Q000662:veterinary*; D005260:Female; D005670:Fusarium / Q000302:isolation & purification / Q000502:physiology; D006651:Histocytochemistry; D006734:Horse Diseases / Q000382:microbiology / Q000628:therapy*; D006736:Horses; D008297:Male; D008825:Miconazole / Q000627:therapeutic use; D011206:Povidone-Iodine / Q000627:therapeutic use; D012189:Retrospective Studies; D012837:Silver Sulfadiazine / Q000627:therapeutic use; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000502:physiology
D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D008825:Miconazole; D011206:Povidone-Iodine; D012837:Silver Sulfadiazine