Brooks D.E., Andrew S.E., Denis H., Strubbe D.T., Biros D.J., Cutler T.J., Samuelson D.A., Gelatt K.N.
Departments of Large and Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, 2015 SW 16 Ave, Gainesville, FL 32601-0126, USA.
Vet Ophthalmol. 2000;3(2-3):83-86. doi: 10.1046/j.1463-5224.2000.00128.x.
Purpose To describe the clinical appearance of corneal epithelial cell microerosions associated with keratomycosis in the horse. METHODS: Retrospective clinical study. RESULTS: Multifocal, punctate, superficial corneal opacities with positive rose bengal retention were noted in six horses with presumed 'viral keratitis'. Faint fluorescein staining was also present in three cases. Equine herpesvirus tissue culture inoculation was negative for a cytopathic effect in three cases. Aspergillus (n = 3), Curvularia (n = 1), and an unidentified fungus (n = 1) were cultured in five horses, and hyphae found on corneal cytology from the sixth. Mixed bacterial infections were present in three eyes. The eyes of two horses with Aspergillus progressed to deep melting corneal ulcers that required surgical therapy. The microerosions remained superficial, but persistent in the other four eyes. Natamycin was utilized topically in all six horses. Transmission electron microscopy from case 6 revealed mucin layer disruption, an intact corneal epithelial cell layer, and fungal attachment to degenerating epithelial cells. The visual outcome was positive in all six horses, although healing was prolonged (48.5 +/- 14.5 days on average in the horses with no surgery; 62 days on average in the two horses that required surgery). CONCLUSIONS: Complete removal or full-thickness penetration of the corneal epithelial cell barrier may not be necessary to allow fungal adherence and initiation of keratomycosis in the horse. Prior to colonization and invasion of the horse cornea, fungi may induce changes in the mucin layer of the tear film that result in or are associated with rose bengal positive microerosions of the superficial corneal epithelium. Horses with painful eyes, and eyes with superficial, multifocal corneal opacities should have their corneas stained with both fluorescein and rose bengal as fungal microerosions may stain weakly, or not at all, with fluorescein, and may thus be mistaken for presumed 'viral keratitis' of the horse.
描述马角膜真菌病相关的角膜上皮细胞微糜烂的临床表现。方法：回顾性临床研究。结果：6匹疑似“病毒性角膜炎”的马出现多灶性、点状、浅层角膜混浊，孟加拉玫瑰红染色阳性。3例还存在轻微的荧光素染色。3例马疱疹病毒组织培养接种未出现细胞病变效应。5匹马培养出曲霉菌（n = 3）、弯孢霉菌（n = 1）和一种未鉴定的真菌（n = 1），第6匹马的角膜细胞学检查发现菌丝。3只眼存在混合细菌感染。2匹感染曲霉菌的马的眼睛发展为深层角膜溃疡，需要手术治疗。另外4只眼的微糜烂仍局限于浅层，但持续存在。所有6匹马均局部使用了那他霉素。病例6的透射电子显微镜检查显示粘蛋白层破坏、角膜上皮细胞层完整，真菌附着于退变的上皮细胞。所有6匹马的视力预后良好，尽管愈合时间延长（未手术的马平均48.5±14.5天；2匹需要手术的马平均62天）。结论：马角膜真菌病中，真菌附着并引发感染可能并不需要角膜上皮细胞屏障完全被清除或全层穿透。在真菌定植和侵入马角膜之前，真菌可能会引起泪膜粘蛋白层的改变，导致浅层角膜上皮孟加拉玫瑰红染色阳性微糜烂或与之相关。眼睛疼痛以及存在浅层多灶性角膜混浊的马，角膜应同时用荧光素和孟加拉玫瑰红染色，因为真菌微糜烂可能荧光素染色较弱或无染色，从而可能被误诊为马的疑似“病毒性角膜炎”。
