Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
Langford Clinical Veterinary Service, University of Bristol, Bristol, UK.
Vet Ophthalmol. 2021 May;24(3):308-312. doi: 10.1111/vop.12887. Epub 2021 Mar 31.
Equine recurrent uveitis (ERU), a chronic, immune-mediated intraocular inflammatory disease, is a common cause of blindness in horses. The severity and recurrent nature of ERU makes it difficult to treat with current therapeutics leading to a poor visual prognosis. The suprachoroidal space (SCS), a potential space between the choroid and sclera surrounding the ocular posterior segment, offers a promising alternative site for drug application to the eye. Corticosteroid administration within this space is hypothesized to be safe and effective at controlling intraocular inflammation, especially in horses with poorly responsive ERU.
Horses with active, poorly responsive ERU.
PROCEDURE(S): A retrospective study was performed with 29 horses (36 total eyes) that received SCS injection of triamcinolone acetonide (TA) with ERU not well controlled with standard uveitis treatment. A standardized ocular inflammation score (OIS) was used to assess inflammation at the time of injection and at follow-ups.
Standardized OIS revealed a significant decrease in ocular inflammation over time after SCS TA administration (p < .004). Adverse effects after injections occurred in <20% of the horses at follow-up, but some of these effects were attributed to chronic inflammation prior to effective treatment, long-term topical corticosteroid use, or complications from hospitalization rather than the SCS injections. Most horses (86.7%) in this study remained visual greater than 3 months after SCS injection.
Based on these results, SCS TA injections appear to be a safe and possible effective treatment modality for managing poorly responsive ERU; further clinical study is warranted.
马复发性眼色素层炎（ERU）是一种慢性、免疫介导的眼内炎症性疾病，是马致盲的常见原因。ERU 的严重程度和复发性使其难以用现有疗法治疗，导致预后不佳。脉络膜上腔（SCS）是一种潜在的空间，位于脉络膜和巩膜之间，环绕眼部后段，为眼部药物应用提供了一个有前途的替代部位。该空间内皮质类固醇的给药被假设为安全且有效，可控制眼内炎症，尤其是在对 ERU 反应不佳的马中。
患有活动性、反应不佳的 ERU 的马。
对 29 匹马（36 只眼）进行了回顾性研究，这些马接受了 SCS 曲安奈德（TA）注射，标准的葡萄膜炎治疗未能很好地控制 ERU。在注射时和随访时使用标准化眼部炎症评分（OIS）评估炎症。
标准化 OIS 显示，在 SCS TA 给药后，眼部炎症随时间显著下降（p<0.004）。在随访时，不到 20%的马出现注射后不良反应，但其中一些不良反应归因于治疗前的慢性炎症、长期局部皮质类固醇使用或住院并发症，而不是 SCS 注射。在这项研究中，大多数马（86.7%）在 SCS 注射后 3 个月以上仍保持视力。
基于这些结果，SCS TA 注射似乎是治疗反应不佳的 ERU 的一种安全且可能有效的治疗方法；需要进一步的临床研究。
