Episcleral cyclosporine A implants for the management of unilateral keratoconjunctivitis sicca in an 8-year-old mare.

An 8-year-old mare was presented for investigation of a 1-month history of blepharospasm, eyelid swelling, corneal edema, and ocular discharge of the right eye (OD). Ophthalmic examination confirmed mucopurulent ocular discharge, conjunctival hyperemia, and a dry, dull appearance to the cornea OD. Schirmer tear test results confirmed an absence of tear production OD (0 mm/min) consistent with keratoconjunctivitis sicca. Treatment with topical 0.2% cyclosporine A resulted in an improvement in clinical signs. An episcleral cyclosporine A implant was placed under standing sedation 5 days after initial presentation. Re-examination 9 days post-operatively confirmed that the mare's tear production in the right eye had improved and no further clinical signs had been observed. Topical medications were gradually discontinued. Re-examinations performed up to 12 months postsurgery showed no recurrence of clinical signs and no adverse effects of the implant. To our knowledge, this is the first report of the use of a cyclosporine A implant in the management of KCS in a horse and highlights its potential as an effective, alternative therapy in the management of KCS in horses.

[1]  B. Gilger,et al.  Use of episcleral cyclosporine implants in dogs with keratoconjunctivitis sicca: pilot study. , 2015, Veterinary ophthalmology.

[2]  B. Gilger,et al.  Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices. , 2014, Veterinary ophthalmology.

[3]  N. Ducharme,et al.  Bilateral parotid duct transposition for keratoconjunctivitis sicca in a Connemara stallion. , 2013, Veterinary ophthalmology.

[4]  B. Gilger,et al.  Advancements in ocular drug delivery. , 2010, Veterinary ophthalmology.

[5]  D. Brooks,et al.  Long-term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis. , 2010, Veterinary ophthalmology.

[6]  B. Nell,et al.  Keratoconjunctivitis sicca attributable to parasympathetic facial nerve dysfunction associated with hypothyroidism in a horse. , 2008, Journal of the American Veterinary Medical Association.

[7]  M. Heath,et al.  Reduced tear production in three canine endocrinopathies. , 2007, The Journal of small animal practice.

[8]  M. Stoskopf,et al.  SUSTAINED RELEASE CYCLOSPORINE THERAPY FOR BILATERAL KERATOCONJUNCTIVITIS SICCA IN A RED WOLF (CANIS RUFUS) , 2006, Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians.

[9]  B. Gilger,et al.  Ocular parameters related to drug delivery in the canine and equine eye: aqueous and vitreous humor volume and scleral surface area and thickness. , 2005, Veterinary ophthalmology.

[10]  J. Beech,et al.  Schirmer tear test results in normal horses and ponies: effect of age, season, environment, sex, time of day and placement of strips. , 2003, Veterinary ophthalmology.

[11]  I. Çelik,et al.  Histologic characteristics and local cellular immunity of the gland of the third eyelid after topical ophthalmic administration of 2% cyclosporine for treatment of dogs with keratoconjunctivitis sicca. , 2002, American journal of veterinary research.

[12]  J. G. Thorne,et al.  Effect of cyclosporine on conjunctival mucin in a canine keratoconjunctivitis sicca model. , 2001, Investigative ophthalmology & visual science.

[13]  M. Calonge.  The treatment of dry eye. , 2001, Survey of ophthalmology.

[14]  S. Crispin.  Tear-deficient and evaporative dry eye syndromes of the horse. , 2000, Veterinary ophthalmology.

[15]  G. McLellan,et al.  Corneal stromal sequestration and keratoconjunctivitis sicca in a horse. , 2000, Veterinary ophthalmology.

[16]  S. Matsuda,et al.  Mechanisms of action of cyclosporine. , 2000, Immunopharmacology.

[17]  D. Panciera.  Hypothyroidism in dogs: 66 cases (1987-1992). , 1994, Journal of the American Veterinary Medical Association.

[18]  J. Beech,et al.  Bilateral keratoconjunctivitis sicca in a horse. , 1994, Equine veterinary journal.

[19]  C. P. Moore.  Eyelid and nasolacrimal disease. , 1992, The Veterinary clinics of North America. Equine practice.

[20]  T. Gerig,et al.  Clinical evaluation of 1% cyclosporine for topical treatment of keratoconjunctivitis sicca in dogs. , 1991, Journal of the American Veterinary Medical Association.

[21]  R. Kaswan,et al.  A new perspective on canine keratoconjunctivitis sicca. Treatment with ophthalmic cyclosporine. , 1990, The Veterinary clinics of North America. Small animal practice.

[22]  B. Spiess,et al.  Eosinophilic granulomatous dacryoadenitis causing bilateral keratoconjunctivitis sicca in a horse. , 1989, Equine veterinary journal.

[23]  S. L. Spurlock,et al.  Keratoconjunctivitis sicca associated with fracture of the stylohyoid bone in a horse. , 1989, Journal of the American Veterinary Medical Association.

[24]  A. Brightman,et al.  Decreased tear production associated with general anesthesia in the horse. , 1983, Journal of the American Veterinary Medical Association.

[25]  R. Merideth,et al.  Parotid duct transposition in the horse , 1981 .

[26]  G. Bratton,et al.  Keratoconjunctivitis sicca secondary to fracture of the mandible. , 1973, Veterinary medicine, small animal clinician : VM, SAC.

[27]  K. V. van Kampen,et al.  Ophthalmic lesions in locoweed poisoning of cattle, sheep, and horses. , 1971, American journal of veterinary research.

[28]  A. Clode.  Chapter 5 – Diseases and Surgery of the Cornea , 2011 .

[29]  E. Giuliano.  Chapter 4 – Equine Ocular Adnexal and Nasolacrimal Disease , 2011 .

[30]  P. Hargrave.  Rhodopsin structure, function, and topography the Friedenwald lecture. , 2001, Investigative ophthalmology & visual science.

[31]  B. Gilger,et al.  Cyclosporine A in veterinary ophthalmology. , 1998, Veterinary ophthalmology.

[32]  Shaw,et al.  Immune-mediated keratoconjunctivitis sicca in a horse , 1994 .