Presumed neuroprotective therapies prescribed by veterinary ophthalmologists for canine degenerative retinal and optic nerve diseases

Abstract

Objective: To investigate veterinary ophthalmologists' use of presumed neuroprotective therapies for degenerative retinal and optic nerve diseases in dogs.Procedures: An online survey was sent to 663 board-certified veterinary ophthalmologists who were Diplomates of the American College of Veterinary Ophthalmologists (ACVO), Asian College of Veterinary Ophthalmologists (AiCVO), Latin American College of Veterinary Ophthalmologists (Colegio Latinoamericano de Oftalmólogos Veterinarios, CLOVE), or European College of Veterinary Ophthalmologists (ECVO). The survey was created using Qualtrics® software and focused on the prescription of presumed neuroprotective treatments for canine glaucoma, sudden acquired retinal degeneration syndrome (SARDS), progressive retinal atrophy (PRA), and retinal detachment (RD). Results: A total of 165 completed surveys were received, representing an overall response rate of 25%, which was comparable across the four specialty colleges. Of all respondents, 140/165 (85%) prescribed some form of presumed neuroprotective therapies at least once in the last five years: 114/165 (69%) for glaucoma, 51/165 (31%) for SARDS, 116/165 (70%) for PRA, and 50/165 (30%) for RD. The three most recommended neuroprotective reagents were the commercial Ocu-GLO™ Vision Supplement for animals, amlodipine, and human eye supplements. Conclusions: Despite lack of published clinical efficacy data, the majority of surveyed board-certified veterinary ophthalmologists previously prescribed a presumed neuroprotective therapy at least once in the last five years in dogs with degenerative retinal and optic nerve diseases.

Manifestations of systemic disease in the retina and fundus of cats and dogs

“…Therefore, there is no current treatment for these conditions. While some advocate the use of nutraceuticals and presumed neuroprotective therapies the practice is not supported by strong research evidence ( 10 ). Furthermore, as demonstrated in people, supplementation with certain vitamins may have adverse effects on specific retinal diseases and therefore caution is advised when advocating for oral supplements ( 11 ).…”

“…The differentiation between glaucoma, trauma or feline metastatic neoplasm is usually straightforward and the diagnosis will guide the recommended treatment plan. While ischemic damage to the retina will often cause severe and irreversible visual deficits, there has been increased interest in the use of neuroprotective agents to spare retinal ganglion cell function ( 10 ).…”

Role of Inflammation in Canine Primary Glaucoma

“…For instance, the flavonoid myricetin was shown to lower inflammatory cytokines in the aqueous humor and trabecular meshwork [ 79 ], while omega-3 fatty acid supplementation reduced pro-inflammatory cytokines in tears and improved dry eye symptoms in human patients with glaucoma [ 80 , 81 ]. In veterinary medicine, two recent surveys showed that nutraceutical use is relatively common for glaucomatous dogs [ 7 , 82 ]; however, well-designed prospective studies are desperately needed as today’s evidence is still uncertain and inconclusive [ 83 ].…”

Endocyclophotocoagulation by pars plana approach in the management of refractory glaucoma with prior phacoemulsification and Ahmed gonioimplantation in a dog

“…Oral medication protocol included gabapentin (10 mg/kg PO q12-8 h; Camber Pharmaceuticals Inc.), prednisone (0.5 mg/kg PO q48 h; West-ward Pharmaceuticals Corp.), methazolamide (2 mg/kg PO q12 h; Ani Pharmaceuticals Inc.), and Ocu-GLO® as a neuroprotective antioxidant supplement. 3 Despite aggressive medical therapy, the patient developed glaucoma in the contralateral eye (OD) 14-days post-phacoemulsification with IOPs of 80 and 18 mmHg OD and OS, respectively. The owner elected to proceed with goniovalve placement OD and the same surgical technique was performed 14-days post-phacoemulsification.…”

“…Topical medication protocol in both eyes included latanoprost 0.005% q8 h (Sandoz Inc.), dorzolamide hydrochloride 2%/timolol maleate 0.5% q6 h (Bausch & Lomb), demecarium bromide 0.125% (Wedgewood Pharmacy), prednisolone acetate 1% q12 h (Pacific Pharmaceuticals USA Inc.), neomycin‐polymyxin B‐sulfate bacitracin zinc q12 h (Bausch & Lomb). Oral medication protocol included gabapentin (10 mg/kg PO q12‐8 h; Camber Pharmaceuticals Inc.), prednisone (0.5 mg/kg PO q48 h; West‐ward Pharmaceuticals Corp.), methazolamide (2 mg/kg PO q12 h; Ani Pharmaceuticals Inc.), and Ocu‐GLO® as a neuroprotective antioxidant supplement 3 . Despite aggressive medical therapy, the patient developed glaucoma in the contralateral eye (OD) 14‐days post‐phacoemulsification with IOPs of 80 and 18 mmHg OD and OS, respectively.…”