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- Author or Editor: James E. Gaarder x
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Objective—
To evaluate the efficacy of itraconazole-dimethyl sulfoxide ointment for treatment of keratomycosis in horses in the northeastern United States.
Design—
Prospective clinical trial.
Animals—
9 horses (10 affected eyes).
Procedure—
All horses treated for keratomycosis at Cornell University between July 1994 and July 1996 were included in the study. The diagnosis of keratomycosis was confirmed by cytologic examination, and all horses were treated with 0.25 ml of a 1% itraconazole-30% dimethyl sulfoxide petrolatum-based ointment, applied to the affected eye every 4 hours.
Results—
Topical application of itraconazole-dimethyl sulfoxide ointment (q 4 h) resolved keratomycosis in 8 of 10 eyes; mean duration of treatment was 34.6 days (range, 16 to 53 days).
Clinical Implications—
Results of this study indicate topical administration of itraconazole-dimethyl sulfoxide ointment may provide an additional treatment option for horses with keratomycosis. (J Am Vet Med Assoc 1997;211:199–203)
Objective
To compare initial clinical appearances, healing mechanisms, risk factors, and outcomes of horses with fungal keratitis.
Design
Retrospective analysis.
Animals
52 horses (53 eyes) with fungal keratitis.
Procedure
Medical records and clinical photographs of eyes were reviewed. Keratomycoses were categorized on the basis of clinical appearance at initial examination and pattern of healing.
Results
Five distinct forms of mycotic keratitis were recognized. Of 53 affected eyes, 34 (64%) retained sight and had varying degrees of corneal scarring after treatment, 6 (11%) had a cosmetic appearance but were blind, and 13 (25%) were enucleated. Bacterial-like ulcers were the most frequent type and the most difficult for predicting outcome. Eyes affected by superficial fungal keratitis were likely to be chronically infected and to require debridement and extended treatment but usually healed with minimal scarring. Keratomycosis with a surrounding furrow resulted in a grave prognosis. Aspergillus organisms were isolated from 9 of 10 such eyes. Cake-frosting material was a positive prognostic sign. Fungal corneal stromal abscesses tended to be caused by yeast.
Clinical Implications
This information will aid practitioners in recognizing various forms of fungal keratitis and guide them when making therapeutic decisions and prognoses for affected horses. (J AM Med Assoc 1998;213:105-112)
