Os glicosaminoglicanos possuem ação inibidora da plasmina, uma enzima fibrinolítica encontrada em altas concentrações em córneas lesadas, além de ação anabólica sobre fibroblastos, condrócitos e sinoviócitos. O objetivo desta pesquisa foi estudar os efeitos clínicos da instilação tópica de uma associação de ciprofloxacina e sulfato de condroitina “A” sobre a cicatrização de úlceras corneanas experimentais produzidas em cavalos. Para isto, foram utilizados 10 olhos de cinco cavalos, nos quais a córnea foi submetida à trefinação central e observação durante 24 horas para início dos tratamentos. Considerando-se cada animal como seu próprio controle, os olhos do lado direito compuseram o grupo controle, nos quais se instilou colírio de tobramicina quatro vezes ao dia e os olhos do lado esquerdo o grupo tratamento, submetidos à instilação de uma associação de sulfato de condroitina “A” com ciprofloxacina duas vezes ao dia. Os cavalos foram examinados a cada dois dias, durante 30 dias, para avaliação dos sinais clínicos. A cicatrização das úlceras foi confirmada por prova de retenção de fluoresceína negativa. Os olhos tratados com sulfato de condroitina “A” e ciprofloxacina apresentaram redução precoce dos sinais clínicos e preenchimento do leito da úlcera com tecido cicatricial de melhor qualidade, obtendo cicatrização sem leucoma em 80% dos olhos em 14 dias. Os olhos controle apresentaram edema corneano e neovascularização mais importantes e a redução dos sinais clínicos, bem como a cicatrização iniciaram-se tardiamente, resultando em discreto leucoma.
A three years old quarter mile mare weighing 500 kilograms and on the last third of pregnancy was received showing signs of severe pain in the left eye. The right eye was normal. This animal was treated, before consultation, with gentamycin eye drops with no success. On the instrumental ophtalmic examination, using biomicroscope, direct ophtalmoscope and flattening tonometer, was observed widespread conjunctivitis, hiperemia involving conjunctive and episclera, edema of cornea, hypopyon, myosis, blackened iris and ocular hypotonia. No changes were seen in the subsequent segment. This signs allowed the diagnosis of anterior subacute uveitis. The treatment, objectifying the ocular imunossupression and maintenance of iris rest, begun. For that it was given: two percent atropine eye drops, tem percent phenylephrin eye drops, one percent prednisone eye drops and one percent prednisone ointment. On the first day of treatment a injection of a two percent solution of bethametasone was given into the sub-conjuctive bulbar space. To the end of fourth week, the eye was calm and the patient was sent home. Three weeks later, the same left eye repeated the same symptoms and the treatment was the same as before except for the replacement of prednisone ointment by a two percent cyclosporine ointment. After 10 days symptoms were gone and the treatment was maintained until the 25th day, when both eyes started to present photophobia, epiphora and blepharospasm. Biomicroscopic examination revealed, in the central area of both corneas, ulcers with a white grayish infiltrate and satellite lesion without vascularization and presenting endothelial plates. It was suspected that ulcers could have a mycotic origin and current treatment was stopped. Cytological exam and biopsy of both the conjunctives and the corneas was carried out. These exams revealed the presence of Aspergillus spp. and Gram positive cocci allowing the diagnosis of mycotic ulcerous keratitis. The treatment was performed by use of itraconazole ophtalmic ointment in a thirty percent dimetilsulphoxide base and one percent cyprophloxacine and condroitine sulphate eye drops. After 15 days of treatment, the signs were gone and only the left eye ulcer still exist. Then it was decided to perform a superficial keratectomy together with a 180 degrees bulbar conjunctival autograft. In this case, probably the imune supressive chronic treatment modified the ocular biota, favoring opportunistic infection with Aspergillus spp. After 45 days of antifungical treatment, the animal left the Hospital both the two eyes showing minimum leucoma but without visual deficit.
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