title: An association between systemic cyclosporine administration and development of acute bullous keratopathy in cats.
abstract: OBJECTIVE
  To determine whether any association exists between the onset of feline acute bullous keratopathy (ABK) and administration of systemic corticosteroid or immunosuppressive therapy.
  
  
  METHODS
  Medical records of cats diagnosed with ABK between the years of 2000 and 2008 were retrospectively reviewed. Breed, age at diagnosis, weight, systemic disease status, eye affected, ophthalmic examination findings, systemic and topical therapy instituted, dosage and duration of therapy, visual outcome and histopathological analyses were recorded in cases meeting the inclusion criteria.
  
  
  RESULTS
  A total of 12 cats of a surveyed population of 70 167 met the inclusion criteria with 17/24 eyes affected by ABK. Medical and/or surgical therapy was utilized for management of ABK with 13/17 eyes remaining sighted at the time of last follow-up. In a subset of cases corneal cytology, aerobic bacterial culture, FHV-1 PCR, virus isolation and/or histopathology were performed; no infectious organisms were identified. A rupture in Descemet's membrane of the cornea was identified histologically in two globes. A total of 10 of 12 cats had been previously diagnosed with ongoing systemic disease. A total of 10 of 12 cats were receiving systemic therapy, and a significant association (P < 0.001) was noted between systemic administration of corticosteroids and/or cyclosporine A and the development of ABK. A total of 8 of 10 cats were administered oral prednisolone at doses between 1-2 mg/kg every 12-24 h. A total of 5 of 8 cats receiving oral prednisolone were concurrently administered oral cyclosporine at doses of 1.5-7 mg/kg every 12-24 h. Systemic cyclosporine therapy was found to be a significant risk factor (P < 0.001) for ABK development, while systemic prednisolone was not significant (P = 0.10).
  
  
  CONCLUSIONS
  Systemic cyclosporine administration appears to be a risk factor for development of ABK in the population of cats studied.
authors.affiliation: Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Pierce
authors.affiliation: Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
authors.forename: David A
authors.identifier: http://orcid.org/0000-0002-4237-0371
authors.initials: DA
authors.lastname: Wilkie
authors.affiliation: Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Gemensky-Metzler
authors.affiliation: Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Curran
authors.affiliation: Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Townsend
authors.affiliation: Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Petersen-Jones
authors.affiliation: Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA.
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Bartoe
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D002371:Cat Diseases / Q000139:chemically induced* / Q000473:pathology; D002415:Cats; D015715:Corneal Edema / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D011239:Prednisolone / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone
keywords: Descemet's membrane rupture; bullous keratopathy; cornea edema; cyclosporine; feline; prednisolone