Knickelbein Kelly E, Luethy Daniela, Thomasy Sara M, Reilly Christopher, Strom Ann R, Lassaline Mary E
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California.
New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania.
Vet Ophthalmol. 2019 Jul;22(4):510-519. doi: 10.1111/vop.12621. Epub 2019 Jan 31.
(a) To evaluate the epidemiology of equine eosinophilic keratoconjunctivitis (EK) in the western United States, (b) to ascertain the efficacy of keratectomy and diamond burr debridement vs medical management alone, (c) to determine the efficacy of various medical therapies, and (d) to further characterize the histopathologic findings of the disease in horses.
Twenty-nine horses (47 eyes) diagnosed with EK from 1993 to 2017.
Retrospective medical record review; owner questionnaire.
Average age of presentation was 11 ± 4 years. Warmbloods were significantly overrepresented (P = 0.024). Twenty horses were treated with medical therapy alone, five were treated with superficial lamellar keratectomy, and four were treated with diamond burr debridement. Follow-up data were available for 38 eyes of 23 horses. Median time to resolution for horses treated with either superficial keratectomy or diamond burr debridement (62 days) was not statistically significantly different from those that underwent medical therapy alone (46 days; P = 0.33). Eyes treated with topical steroids had a statistically significant longer median time to resolution (61 days) compared to those that did not receive topical steroid (44 days; P = 0.023). Common histopathologic findings in keratectomy samples included the presence of eosinophils, vascularization, and an eosinophilic membrane spanning areas of ulceration.
In this population, time to EK resolution was similar for horses treated with medical and surgical management. The use of topical steroids was associated with a prolonged time to resolution. Keratectomy samples from horses with EK had similar findings to those reported in other species.
(a)评估美国西部马嗜酸性粒细胞性角膜结膜炎（EK）的流行病学情况；(b)确定角膜切除术和钻石磨头清创术与单纯药物治疗相比的疗效；(c)确定各种药物治疗的疗效；(d)进一步描述马匹该疾病的组织病理学发现。
1993年至2017年诊断为EK的29匹马（47只眼）。
回顾性病历审查；主人问卷调查。
就诊时的平均年龄为11±4岁。温血马的比例显著过高（P = 0.024）。20匹马仅接受药物治疗，5匹马接受了浅表板层角膜切除术，4匹马接受了钻石磨头清创术。23匹马的38只眼有随访数据。接受浅表角膜切除术或钻石磨头清创术治疗的马匹的中位恢复时间（62天）与仅接受药物治疗的马匹（46天）相比，差异无统计学意义（P = 0.33）。与未接受局部类固醇治疗的眼睛相比，接受局部类固醇治疗的眼睛的中位恢复时间在统计学上显著更长（61天）（44天；P = 0.023）。角膜切除术样本中常见的组织病理学发现包括嗜酸性粒细胞的存在、血管化以及跨越溃疡区域的嗜酸性膜。
在该群体中，接受药物和手术治疗的马匹EK恢复时间相似。局部类固醇的使用与恢复时间延长有关。EK马匹的角膜切除术样本的发现与其他物种报道的相似。
