Case Report of a Mare Diagnosed with a Metastatic Mammary Carcinoma after the Excision of a Recurrent Intraocular Neuroepithelial Tumor.

A 24-year-old Irish Cob mare was presented with a peripheral iris mass, which was surgically resected and diagnosed as an undifferentiated neuroepithelial tumor. A few months later, a relapse occurred with histological features characterized by a more solid appearance and squamous differentiation. Subsequently, the mare was presented with rapidly spreading multiple subcutaneous masses and, at the onset of neurological signs, was humanely euthanized and subjected to a complete post mortem examination. The necropsy confirmed the presence of numerous widespread masses in the subcutaneous tissue, several internal organs, and mammary gland. Histological and immunohistochemical (IHC) examinations were performed on all masses, allowing the diagnosis of mammary carcinoma with several visceral and subcutaneous metastases. Considering the post mortem findings, the second intraocular mass was submitted to histological and IHC re-evaluation to differentiate it from an intraocular metastasis of the mammary carcinoma. The results of the histological and IHC analyses confirmed the diagnosis of neuroepithelial tumor relapse. This is the first case of a metastatic mammary carcinoma concurrent with a recurrent intraocular neuroepithelial tumor in a mare. This case was a challenge for both clinicians and pathologists involved and highlighted the importance of post mortem and IHC evaluations.

Retrospective evaluation of phacoemulsification and aspiration in 41 horses (46 eyes): visual outcomes vs. age, intraocular lens, and uveitis status.

OBJECTIVE: To determine the effect of age at the time of surgery, intraocular lens (IOL) placement, and presence of chronic uveitis on visual outcome after phacoemulsification and aspiration (PA) of cataracts in horses. ANIMALS STUDIED: Records of 41 horses (46 eyes) receiving unilateral or bilateral PA. METHODS: Retrospective analysis of horses receiving unilateral or bilateral PA at the NCSU-VTH (35 horses, 39 eyes) and in Northern Italy (six horses, seven eyes) was performed. Visual status at last follow-up was compared to age at the time of surgery, IOL status, and presence of chronic uveitis preoperatively. Seven horses with chronic uveitis also underwent placement of a suprachoroidal cyclosporine implant. Clinical ophthalmic examinations and owner questionnaires were used to evaluate visual status. RESULTS: Twenty-one of 46 eyes (46%) received an IOL and 12 of 46 eyes (26%) had chronic uveitis. Overall, 25 of 46 eyes (54%) were visual at last follow-up (mean 35.1 ± 34.8 months). Age (mean 8.6 ± 7.7 years) was not significantly associated with visual outcome. Fourteen of 21 (67%) pseudophakic eyes and 11 of 25 (44%) aphakic eyes were visual at last follow-up (P = 0.342). Eyes with preoperative chronic uveitis were significantly less likely to be visual (3 of 12 eyes [25%]) than horses without preoperative chronic uveitis (22 of 34 eyes [65%]) (P = 0.023). CONCLUSIONS: Horses with chronic uveitis had significantly less favorable visual outcome after PA. Older age at surgery and IOL use were not associated with poor visual outcome.

Corneal dystrophy in Friesian horses may represent a variant of pellucid marginal degeneration.

OBJECTIVE: To describe the clinical presentation, treatment, and outcome of a corneal dystrophy in Friesian horses and to analyze affected horses' pedigrees to investigate its heritability. ANIMALS: Nine Friesians with bilateral disease were identified. PROCEDURE: Retrospective medical record review was used to identify Friesian horses exhibiting bilateral symmetric corneal lesions. Variables identified from medical records included patient sex and age at diagnosis; location, depth and size of corneal lesions; medical and surgical therapy instituted; and visual outcome. A four-generation pedigree for each included horse was used to construct a combined pedigree. RESULTS: The nine included horses had an average age at diagnosis of the first eye of 10.7 years, with males (8/9) significantly more frequently affected than females (1/9), P = 0.012. Lesions were inferior and averaged 5 mm in diameter. Depth ranged from superficial facets to perforations, which developed in nine of 18 eyes. Eight of nine perforations were surgically repaired, with seven of eight repaired eyes visual at last follow-up. All nine eyes that had not perforated remained visual. All affected horses shared a common ancestor within six generations. CONCLUSIONS: This form of corneal dystrophy in Friesian horses, characterized by bilateral symmetric stromal loss, appears to be progressive but responds well to surgical repair, occurs more frequently in males, may have a genetic component in Friesian horses, and may be a variant of pellucid marginal degeneration.

Diode laser photoablation to correct distal nasolacrimal duct atresia in an adult horse.

CASE DESCRIPTION: An 8-year-old Hanoverian mare was presented for chronic mucopurulent discharge in the left eye, which was responsive to topical antibiotic therapy. CLINICAL FINDINGS: The nasolacrimal orifice was absent in the left nasal meatum, and anterograde irrigation of left nasolacrimal duct was not possible. Dacryocystorhinography was performed and revealed about 4-6 cm of distal nasolacrimal duct atresia. SURGICAL TREATMENT AND OUTCOME: A novel technique was attempted with the horse under standing sedation using an urinary catheter and a 980 nm diode laser with a 600 µm diameter flexible bare quartz fiber. A nasolacrimal orifice was successfully created by ablating the nasal mucosa directly over the tip of the urinary catheter, and patency was maintained with a soft catheter sutured in place for 4 weeks. At 3 months re-evaluation, the left nasolacrimal duct was patent and functional. CONCLUSION: This case report describes a successful novel surgical technique used to correct congenital distal nasolacrimal duct atresia in an adult horse under standing sedation. Advantages over conventional surgical techniques are shorter operating time and limited hemorrhage.

Treatment of immune-mediated keratitis in horses with episcleral silicone matrix cyclosporine delivery devices.

PURPOSE: To describe the use of episcleral silicone matrix cyclosporine (ESMC) drug delivery devices in horses with immune-mediated keratitis (IMMK) with evaluation of tolerability and efficacy in long-term control of inflammation. METHODS: Retrospective study. ESMC implants (1.2 cm length, 30% wt/wt cyclosporine (CsA) in silicone; with approximately 2 µg/day steady-state release for at least 400 days) were used. RESULTS: Nineteen horses (20 eyes) received two or more ESMC implants for superficial stromal (n = 9), midstromal (n = 3), or endothelial (n = 5) IMMK. Three additional horses received two or more ESMC implants for pigmentary keratouveitis (PK). Nine eyes of eight horses with superficial and five eyes of five horses with endothelial IMMK were well controlled after placement of ESMC implants (mean follow-up 176.8 and 207.2 days, respectively). Horses with midstromal IMMK and PK were not controlled with ESMC implants alone, but instead required frequent use of other medications or surgery to control the disease. The mean duration of disease prior to ESMC implantation of horses with midstromal IMMK was 495 ± 203.9 days, compared with 121.6 ± 92.7 days with superficial IMMK. ESMC implants were well tolerated by all horses without documented loss of the device. CONCLUSIONS: Results from this preliminary retrospective study suggest that the ESMC implants were well tolerated and associated with treatment success with superficial and endothelial IMMK, especially if placed early in the disease process. Further study is needed to determine the duration of efficacy, number of implants required, and better therapies for chronic midstromal IMMK and pigmentary keratouveitis.

Bilateral nodular lymphocytic conjunctivitis in a horse.

A Russian jumper horse presented because of an ocular perilimbal conjunctival mass and, on clinical examination, two bilateral conjunctival masses were found, of different size and conformation. Attempts at complete excision of the left eye mass and excisional biopsy of the right eye mass were performed. The left eye mass recurred rapidly, but resolved completely after topical corticosteroid therapy. The two lesions had similar histopathologic features, characterized by focal, chronic, primarily lymphocytic conjunctivitis with follicular lymphoid hyperplasia. Special histopathologic staining techniques (Gomori methenamine silver and acid fast stains) and immunohistochemistry (for CD3, BLA36 and lysozyme) failed to reveal any etiologic agents and indicated an inflammatory lesion composed of a heterogeneous population of lymphocytes and macrophages (nodular lymphocytic conjunctivitis). The lesions were indistinguishable, clinically and behaviorally, from what has been reported as 'conjunctival pseudotumor' in the horse. Equine conjunctival pseudotumor/nodular lymphocytic conjunctivitis has been reported to be unilateral and have a good prognosis after partial or complete surgical excision. This is the first reported case of bilateral nodular lymphocytic conjunctivitis in a horse and for which surgical excision alone was not curative.