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Tratamento medicamentoso de ulceração corneana e abscesso estromal em equinos / Medicament Treatment of Corneal Ulcer and Stromal Abscess in Horses

Santos, Fernanda Carlini Cunha dos; Santos, Alice Correa; Schmith, Rúbia Alves; Nogueira, Carlos Eduardo Wayne; Curcio, Bruna da Rosa.
Acta sci. vet. (Impr.); 41(supl.1): Pub. 26, 2013. ilus
Artigo em Português | VETINDEX | ID: biblio-1372646


Background: The equine eyelids and cilia protect the eye and promote normal ocular physiological function. Disorders in these structures may result in corneal alterations such as ulcers and stromal abscess. An abscess is a focal mixture of cellular debris, necrotic tissue, leucocytes and possibly infectious agents that initially create a lesion surrounded by a zone of reactive infl ammation. Ulcers and corneal stromal abscess cause severe ocular pain and loss of vision quality in horses. Medical and surgical treatments for stromal abscess have been developed and have evolved over many years. The aim of this work is to report a case of stromal abscess in a horse, after a corneal ulcer related to eyelid deficiency, focusing on therapeutic methods. Case: A 10-year-old crossbreed mare was referred to the Veterinary Clinics Hospital (HCV) of UFPel with an ophthalmic disorder. The mare had an eyelid lesion 2 years before, and since this event she had had recurrent episodes of ophthalmologic disorders. On attendance at the HCV, the mare had photophobia, blepharospasm, conjunctival hyperemia, neovascularization, myosis, uveitis, intense ocular pain, eyelid deficiency and a corneal ulcer about 2 cm long x 2 cm wide in the right eye. Surgical correction of eyelid and corneal disorder was recommended, but not authorized by the owner. Treatment was based on cleaning with physiological solution, gentamicin eyewash, autologus serum every 4 h, atropine 1% every 12 h topically, flunixin meglumin every 12 h intravenously. After 7 days, the corneal ulcer shrank, although there was no improvement in blepharospasm and ocular pain. A corneal abscess 3 cm x 2 cm was noticed. Gentamicin eyewash and autologus serum were administered topically every 4 h for 10 more days. After 14 days of treatment, there was neither blepharospasm nor corneal ulcer and the abscess was shrinking. Gentamicin eyewash was maintained every 6h for 3 more days. After 65 days there was minimal scar tissue in the eye. Discussion: The mare had an ocular traumatic injury 2 years ago and since this event she had presented uveitis and corneal ulcer recurrently, due to loss of eyelid and cilia functional integrity. Equine cornea is avascularized and vascularization of the affected lesion is necessary for resolution and abscess healing. Medical treatment of superfi cial stromal abscess is more economical than surgery and can result in good visual outcomes with mild scarring. Medical treatment consists of a combination of antimicrobial, mydriatic/cycloplegic and anti-inflammatory medications. Flunixin meglumin seems to be the most effective intravenous anti-inflammatory for controlling uveitis in horses. The anti-inflammatory dose may be reduced when there is a decrease in the anterior segment signs of infl ammation and ocular pain. Besides systemic colateral effects, anti-inflammatory therapy also reduces corneal vascularization, and therefore should be used carefully. Antibiotic topical therapy is highly recommended, due to ocular microflora and microorganism encapsulation, and it was used in the present report until there was full epithelial healing. A mydriatic/cycloplegic (atropine 1%) drug was administered aiming to dilate the pupil in order to prevent adherences and to reduce ocular discomfort. Antiproteases agents (autologus serum) are recommended when there is a corneal epithelial loss of integrity. This agent reduces collagen degradation and helps corneal healing. Stromal abscess in horses is usually associated with previous corneal ulceration, and in the present report it also involved eyelid functional deficiency. Medical treatment was effective, ensuring quality of future vision for the animal.
Biblioteca responsável: BR68.1