Keratomycoses in 11 horses

Equine keratomycoses in California from 1987 to 2010 (47 cases)

“…Vision retention for horses with keratomycosis was approximately 50% in this study, similar to previous reports of 53–64% [1–4,23]. Although a few studies report positive visual outcomes of 75% or greater [5–7], a guarded prognosis for vision is advisable for equine patients with keratomycosis owing to the risk of extensive corneal scarring, uncontrollable uveitis and globe rupture, which can occur despite aggressive treatment.…”

“…The present study showed that all tested isolates were sensitive (67%) or intermediately sensitive (33%) to natamycin. Natamycin – a polyene antifungal antibiotic – is predominantly fungicidal and is the preferred treatment for Fusarium keratitis [2,36], but its major disadvantage is its poor penetration through intact corneal epithelium [37]. Given that nearly 80% of eyes with keratomycosis in the present study were ulcerated, natamycin appears to have potential for the initial treatment of equine keratomycosis in northern California based on the small number of isolates tested.…”

“…Aggressive medical management, sometimes in combination with surgery, is required to achieve a functional outcome in affected horses. Success rates for vision retention in equine keratomycosis vary from approximately 50% [1–4] to ≥90% [5,6]. However, the wide variation in clinical appearance, progression and response to treatment among individual patients complicates diagnosis, management and prognostication for horses with keratomycosis [1,3–5,7–10].…”

Evaluation of the conjunctival fungal flora and its susceptibility to antifungal agents in healthy horses in Switzerland

“…Keratomycosis is a sight‐threatening disease and very often treatment is complicated, needs to be aggressive and of a long duration. Several authors described a 60–70% rate of globe survival treating eyes with keratomycosis medically and/or surgically, while one author arrived at a globe survival rate of 95% . Not many antifungal drugs exist to be used as topical ocular medications.…”

Treatment of six cases of equine corneal stromal abscessation with intracorneal injection of 5% voriconazole solution

“…Therefore, histopathology and culture of keratectomy specimens may be the only way to obtain a definitive etiological diagnosis and institute proper antimicrobial therapy . In some cases, clinical course, depth of abscessation, intensity of anterior uveitis, the presence of satellite lesions, time of year, and the geographic location of the animal may support the presumption of fungal involvement . For the cases in this report, depth of abscessation, level of anterior uveitis, clinical course, and the commonality of fungal infection in Oklahoma supported treatment with voriconazole.…”