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

Gilger, Brian C.; Stoppini, Riccardo; Wilkie, David A.; Clode, Alison B.; Pinto, Nelson H.; Hempstead, Julie E.; Gerding, Joseph C.; Salmon, John L.

doi:10.1111/vop.12087

Cited by 30 publications

(34 citation statements)

References 22 publications

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“…Clinically, IMMK presents with various degrees of corneal vascularization, opacification and is generally nonpainful. Several types of IMMK have been described based on where the inflammation is localized within the cornea (superficial, stromal and endothelial) . Histopathologically, the disease presents as a predominately lymphocytic‐plasmacytic infiltration of the corneal tissue consistent with a dysregulated immune microenvironment .…”

Section: Introductionmentioning

confidence: 99%

“…Chronic therapy can be difficult in equine patients, raising issues with compliance. Additionally, treatment options other than surgery for cases nonresponsive to traditional immunomodulating therapy are limited …”

Section: Introductionmentioning

confidence: 99%

“…Several types of IMMK have been described based on where the inflammation is localized within the cornea (superficial, stromal and endothelial). 3,4 Histopathologically, the disease presents as a predominately lymphocytic-plasmacytic infiltration of the corneal tissue consistent with a dysregulated immune microenvironment. 1 While not directly globethreatening, this condition can reduce vision due to chronic scarring, development of secondary infections, and in some conditions, development of diffuse corneal edema.…”

Section: Introductionmentioning

confidence: 99%

“…3 IMMK oftentimes requires therapy consisting of long-term immunomodulatory medications combined with anti-inflammatory therapy to control and treat recurrence. [2][3][4] Chronic therapy can be difficult in equine patients, raising issues with compliance. Additionally, treatment options other than surgery for cases nonresponsive to traditional immunomodulating therapy are limited.…”

Section: Introductionmentioning

confidence: 99%

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Subconjunctival bone marrow‐derived mesenchymal stem cell therapy as a novel treatment alternative for equine immune‐mediated keratitis: A case series

Davis

Schnabel

Gilger

2019

Veterinary Ophthalmology

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Equine immune‐mediated keratitis (IMMK) leads to increased corneal opacity and inflammation secondary to an alteration of the local immune system. Bone marrow‐derived mesenchymal stem cells (BM‐MSC) have been shown to modulate the immune system by downregulating inflammation. Four horses with unilateral IMMK poorly responsive to traditional medical treatments underwent novel, autologous subconjunctival BM‐MSC therapy. Bone marrow was harvested and processed as previously described for equine orthopedic disease. Horses received autologous subconjunctival BM‐MSC injections approximately every 3‐4 weeks for 1‐5 treatments total. Horses were maintained on their current medical treatment regimen throughout the BM‐MSC treatment period. Three horses had a positive response to therapy as demonstrated by an increase in corneal clarity, a decrease in neovascularization and a reduction in surface irregularity. One horse was nonresponsive to therapy. These experimental results demonstrate the safety and potential efficacy of an innovative solution for IMMK.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subconjunctival bone marrow‐derived mesenchymal stem cell therapy as a novel treatment alternative for equine immune‐mediated keratitis: A case series

Davis

Schnabel

Gilger

2019

Veterinary Ophthalmology

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“…Intracameral, biodegradable latanoprost‐, bimatoprost‐, and travoprost‐releasing devices have been tested successfully in normal dogs and dogs with POAG, but we are not aware of any plans to move these devices into veterinary clinical application . The use of ocular, slow‐releasing drug implants is not new in veterinary ophthalmology since cyclosporine devices are being used in both horses and dogs for recurrent uveitis, immune‐mediated keratitis, and keratoconjunctivitis sicca …”

Section: Optimization Of Iop‐lowering Medical Treatmentmentioning

confidence: 99%

The future of canine glaucoma therapy

Komàromy

Bras²,

Esson

et al. 2019

Veterinary Ophthalmology

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Canine glaucoma is a group of disorders that are generally associated with increased intraocular pressure (IOP) resulting in a characteristic optic neuropathy. Glaucoma is a leading cause of irreversible vision loss in dogs and may be either primary or secondary. Despite the growing spectrum of medical and surgical therapies, there is no cure, and many affected dogs go blind. Often eyes are enucleated because of painfully high, uncontrollable IOP. While progressive vision loss due to primary glaucoma is considered preventable in some humans, this is mostly not true for dogs. There is an urgent need for more effective, affordable treatment options. Because newly developed glaucoma medications are emerging at a very slow rate and may not be effective in dogs, work toward improving surgical options may be the most rewarding approach in the near term. This Viewpoint Article summarizes the discussions and recommended research strategies of both a Think Tank and a Consortium focused on the development of more effective therapies for canine glaucoma; both were organized and funded by the American College of Veterinary Ophthalmologists Vision for Animals Foundation (ACVO‐VAF). The recommendations consist of (a) better understanding of disease mechanisms, (b) early glaucoma diagnosis and disease staging, (c) optimization of IOP‐lowering medical treatment, (d) new surgical therapies to control IOP, and (e) novel treatment strategies, such as gene and stem cell therapies, neuroprotection, and neuroregeneration. In order to address these needs, increases in research funding specifically focused on canine glaucoma are necessary.

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