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Estudo retrospetivo do tratamento Queratite imunomediada em equinos com implantes episcerais de libertação prolongada de ciclosporina com matriz de silicone
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Authors
Advisor(s)
Abstract(s)
Introdução: Na área da oftalmologia equina, a queratite imunomediada é classificada como uma
queratite não ulcerativa crónica, que decorre por um período superior a três meses, sendo que o seu
perfil epidemiológico e terapêutico são ainda temas pouco explorados na literatura.
Objetivos: Especificar as características epidemiológicas, clínicas e terapêuticas da queratite
imunomediada, e em particular descrever o uso de dispositivos episclerais de libertação prolongada
de ciclosporina A em silicone, a fim de avaliar a segurança e eficácia no controlo da inflamação a
curto prazo.
Métodos: Estudo retrospetivo. Foram utilizados implantes episclerais de libertação de ciclosporina
com matriz de silicone.
Resultados: Foram incluídos 28 equídeos, divididos em quatro grupos com base na profundidade da
lesão na córnea: epitelial, estromal superficial, estromal média e endotelial. Observou-se uma
predominância de apresentação de lesão estromal superficial. A população do estudo apresentava
idade média no momento dos primeiros sintomas de 12 ± 6,3 anos e era composta por uma maioria
de fêmeas. Dos equinos que receberam implantes (em média 3,4 por olho), estes foram bem
tolerados. A curto prazo, todos os casos de queratite epitelial (3/3) e a maioria dos casos de queratite
estromal superficial (4/7) foram bem controlados com os implantes (acompanhamento médio de 529,7
e 177,1 dias respetivamente). Nos casos de queratite estromal média, não foi observado o sucesso
terapêutico desejado.
Conclusões: Este estudo mostra que os implantes libertadores de ciclosporina A foram bem tolerados
e que são potencialmente eficazes no tratamento de queratite imunomediada epitelial e estromal
superficial a curto prazo em equinos. No entanto, são necessários estudos mais abrangentes com
amostra maior e período de estudo mais longo para avaliar a eficácia a longo prazo e a duração dos
seus efeitos.
Introduction: In the area of equine ophthalmology, immune-mediated keratitis is classified as a chronic non-ulcerative keratitis, which lasts for a period of more than three months, and its epidemiological and therapeutic profile are still little explored in the literature. Objectives: To specify the epidemiological, clinical and therapeutic charateristics of imune-mediated keratitis, and in particular to describe the use of episcleral prolonged-release silicone cyclosporine A devices, in order to evaluate their safety and efficacy in short-term inflammation control. Methods: Retrospective study. Episcleral silicone matrix cyclosporine implants were used. Results: Twenty-eight horses were included, divided into four groups based on corneal lesion depth: epithelial, superficial stromal, midstromal and endothelial. A predominance of superficial stromal lesion presentation was observed. The study population presented a mean age at the onset of the first symptoms of 12 ± 6.3 years and was composed of a majority of females. Of the horses that received implants (averaging 3,4 per eye), these were well tolerated. In the short term, all cases of epithelial keratitis (3/3) and the majority of the cases of superficial stromal keratitis (4/7) were well managed with the implants (mean follow-up 529,7 and 177,1 days, respectively). In cases of midstromal keratitis, the desired therapeutic success was not observed. Conclusions : This study demonstrated that cyclosporine-releasing implants were well tolerated and potentially effective in the short-term treatment of epithelial and superficial stromal immune-mediated keratitis in horses. However, larger and longer-term studies are needed to evaluate long-term efficacy and duration of effects.
Introduction: In the area of equine ophthalmology, immune-mediated keratitis is classified as a chronic non-ulcerative keratitis, which lasts for a period of more than three months, and its epidemiological and therapeutic profile are still little explored in the literature. Objectives: To specify the epidemiological, clinical and therapeutic charateristics of imune-mediated keratitis, and in particular to describe the use of episcleral prolonged-release silicone cyclosporine A devices, in order to evaluate their safety and efficacy in short-term inflammation control. Methods: Retrospective study. Episcleral silicone matrix cyclosporine implants were used. Results: Twenty-eight horses were included, divided into four groups based on corneal lesion depth: epithelial, superficial stromal, midstromal and endothelial. A predominance of superficial stromal lesion presentation was observed. The study population presented a mean age at the onset of the first symptoms of 12 ± 6.3 years and was composed of a majority of females. Of the horses that received implants (averaging 3,4 per eye), these were well tolerated. In the short term, all cases of epithelial keratitis (3/3) and the majority of the cases of superficial stromal keratitis (4/7) were well managed with the implants (mean follow-up 529,7 and 177,1 days, respectively). In cases of midstromal keratitis, the desired therapeutic success was not observed. Conclusions : This study demonstrated that cyclosporine-releasing implants were well tolerated and potentially effective in the short-term treatment of epithelial and superficial stromal immune-mediated keratitis in horses. However, larger and longer-term studies are needed to evaluate long-term efficacy and duration of effects.
Description
Keywords
Ciclosporina Equinos Implantes Imunomediada Queratite Ciclosporin Equines Implants Imune-mediated Keratitis