Publications by authors named "Phillip A Moore"

24 Publications

  • Page 1 of 1

Comparison of image quality of corneal and retinal optical coherence tomography using sedation and general anesthesia protocols with or without retrobulbar anesthesia in horses.

Am J Vet Res 2021 Nov 1;83(1):72-79. Epub 2021 Nov 1.

Objective: To compare image quality and acquisition time of corneal and retinal spectral domain optical coherence tomography (SD-OCT) under 3 different sedation-anesthesia conditions in horses.

Animals: 6 middle-aged geldings free of ocular disease.

Procedures: 1 randomly selected eye of each horse was evaluated via SD-OCT under the following 3 conditions: standing sedation without retrobulbar anesthetic block (RB), standing sedation with RB, and general anesthesia with RB. Five regions of interest were evaluated in the cornea (axial and 12, 3, 6, and 9 o'clock positions) and fundus (optic nerve head). Three diagnostic scans of predetermined quality were obtained per anatomical region. Image acquisition times and total scans per site were recorded. Corneal and retinal SD-OCT image quality was graded on a subjective scale from 0 (nondiagnostic) to 4 (excellent).

Results: Mean values for the standing sedation without RB, standing sedation with RB, and general anesthesia conditions were 24, 23, and 17, respectively, for total cornea scan attempts; 23, 19, and 19 for total retina-scan attempts; 14.6, 13.2, and 9.2 minutes for total cornea scan time; 19.1, 9.2, and 13.0 for total retina scan time; 2.0, 2.3, and 2.5 for cornea grade; and 2.7, 2.9, and 2.5 for retina grade.

Conclusions And Clinical Relevance: The RB facilitated globe akinesia and improved the percentage of scans in frame and region of interest accuracy for retinal imaging via OCT in horses. Retrobulbar blocks improved clinical image acquisition while minimizing motion artifact.
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http://dx.doi.org/10.2460/ajvr.21.02.0029DOI Listing
November 2021

Clinical and pathologic evaluation of chorioretinal lesions in wild owl species.

Vet Ophthalmol 2021 Sep 29. Epub 2021 Sep 29.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.

Objective: Investigate histopathology and spectral-domain optical coherence tomography (OCT) imaging of wild owls with chorioretinitis and identify any potential correlation with an infectious etiology.

Materials And Methods: Ophthalmic examination and retinal OCT imaging were performed on fifteen great horned (Strix varia) and barred (Bubo virginianus) owls (30 eyes) with chorioretinitis and five owls with normal eyes (10 eyes). Testing to investigate the presence of potential infectious diseases included a complete blood count, biochemistry, protein electrophoresis, West Nile virus (WNV) plaque reduction neutralization test, Toxoplasma gondii modified direct agglutination test, WNV RT-PCR, and Avian Influenza RT-PCR. A necropsy was performed on all owls, including ocular histopathology.

Results: Fundus lesions included retinal detachment (7/15 owls), depigmented lesions (12/15), pigment clumping (8/15), and retinal tear (4/15). All birds were negative for WNV and Avian Influenza on RT-PCR. Of the owls with chorioretinitis, 3/15 were seropositive for WNV and 7/15 for T. gondii. Optical coherence tomography of 25/30 affected eyes revealed outer retinal lesions (19/25 eyes), retinal detachment (16/25), and retinal tears (3/25). Histopathological examination revealed outer nuclear layer atrophy (19/30 eyes), retinal detachment (18/30), retinal tears (7/30), suprachoroidal hemorrhage (12/30), scleral rupture (3/30), and ossicle fracture (3/30).

Conclusions: Although 20% of birds were seropositive for WNV and 46.6% for T. gondii, histopathologic findings supported that the posterior segment lesions in the study group were likely due to blunt ocular trauma rather than an infectious etiology. The results of OCT imaging and histopathology documented retinal changes most consistent with blunt ocular trauma.
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http://dx.doi.org/10.1111/vop.12942DOI Listing
September 2021

Corneoconjunctival transposition with and without ACell for deep corneal ulcer repair in 18 dogs.

Vet Ophthalmol 2020 Sep 13;23(5):884-891. Epub 2020 Aug 13.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.

Objective: To document a case series using corneoconjunctival transposition (CCT) surgery with and without bioscaffolding matrix (ACell ) to repair deep corneal ulcers and perforations in dogs.

Animals Studied: Eighteen dogs of various breeds that presented with deep or perforating corneal ulcers.

Procedures: Corneoconjunctival transposition grafts with or without ACell were sutured using a simple interrupted 8-0 or 9-0 polyglactin 910 pattern.

Results: A total of eighteen dogs (19 eyes) were diagnosed with deep corneal ulcers (n = 7) and perforating corneal ulcers (n = 12). A CCT was performed in all eyes, with ten of them additionally receiving an ACell graft. The majority of lesions were located axially in 14/19 (81%) eyes. Grafts were harvested from dorsal (n = 8), temporal (n = 5), ventral (n = 4), or nasal (n = 2) quadrants. Brachycephalic breeds (13/18) were over-represented. Keratoconjunctivitis sicca was present in 10/19 eyes (52.6%). Bacterial isolates were cultured from 8/19 eyes. Post-operative therapy included topical antibiotics, plasma, cycloplegics, oral antibiotics, and oral nonsteroidal anti-inflammatory drugs. CCT integration with and without ACell occurred at a median of 20 days (range 7-38 days) post-operatively with no significant difference between groups. Median follow-up time was 188 days. Short-term post-operative complications included granulation tissue formation (19/19), corneal edema (4/19), graft retraction (4/19), and anterior synechia (1/19). Long-term complications in 14 eyes with follow-up >30 days included superficial corneal pigmentation (6/14) and epithelial inclusion cysts (5/14). Two eyes were nonvisual at last follow-up due to cataract formation.

Conclusions: Corneoconjunctival transposition with ACell can be utilized for corneal ulcer repair in dogs.
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http://dx.doi.org/10.1111/vop.12815DOI Listing
September 2020

Surgical excision of iridociliary tumors using a postero-anterior cyclo-iridectomy and thermocautery in two dogs.

Vet Ophthalmol 2020 May 1;23(3):579-587. Epub 2020 Apr 1.

Department of Clinical Science, Auburn University, Auburn, Alabama.

Objective: To report the surgical excision of an iridociliary adenoma and iridal melanocytoma using a postero-anterior cyclo-iridectomy in two dogs.

Procedure: A 7 year old neutered male English springer spaniel (case 1) and a 7 year old neutered male Labrador mix (case 2) were presented for evaluation of an intrairidal mass OS.

Results: Complete ophthalmic examination revealed a large, dorsonasal, well-demarcated, intrairidal mass OS. A tan to pink intrairidal mass extending into the iridocorneal angle (case 1) and a pigmented intrairidal mass (case 2) were present. B-mode ultrasonography showed a focal, soft tissue, homogenous mass within the uvea adjacent to and contacting the lens. Neither pars plana involvement nor vitreal extension was present. A postero-anterior cyclo-iridectomy was performed through a polyhedral scleral flap. Thermocautery was used to complete the cyclo-iridectomy (case 1) and partial iridectomy (case 2) to excise the mass en bloc. Histopathology revealed a completely excised iridociliary adenoma (case 1) and iris melanocytoma (case 2). The surgery sites healed without complication. Mild uveitis (cases 1 and 2), scant vitreal hemorrhage (case 1), and mild hyphema (case 2) were present three days postoperatively but had resolved ten days postoperatively. The patients remain visual twenty-two months (case 1) and seven months (case 2) postoperatively with a normal intraocular examination other than an iridal defect and mild dorsonasal lens capsular opacities.

Conclusions: The surgical approach described in these cases is utilized in physician-based medicine. This approach and the use of thermocautery provide a viable surgical option for excision of large iridociliary tumors in dogs.
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http://dx.doi.org/10.1111/vop.12755DOI Listing
May 2020

Preliminary report of postoperative complications of phacoemulsification in Pugs: A multicenter retrospective study of 32 cases.

Vet Ophthalmol 2020 May 11;23(3):442-449. Epub 2020 Mar 11.

Animal Eye Clinic, Denmark, WI, USA.

Objective: To compare complication rates and visual outcomes following phacoemulsification in Pugs versus dogs of other breeds.

Animals Studied: Thirty-two pure-bred Pugs (55 eyes) and 32 dogs of other breeds (56 eyes) undergoing phacoemulsification.

Procedures: Multi-institutional retrospective medical record review of perioperative factors, postoperative complications, and visual outcomes. The reference population of dogs of varying breeds included surgical cases following each Pug case at the same institutions. Perioperative risk factors and postoperative complication rates were compared between the two populations.

Results: Pigmentary keratitis and diabetes mellitus were the most common preoperative comorbidities, found in 75% (P < .001) and 72% (P = .12) of Pugs, respectively. No perioperative factors were significantly associated with postoperative complications in Pugs. Postoperative complication rates were similar between groups; however, the most common complication in Pugs was corneal ulceration (15% of operated eyes), whereas glaucoma was most common in the reference population (13% of operated eyes). Three months postoperatively, vision was preserved in 91% of eyes of Pugs (50/55) and 95% of the reference population (53/56). One year postoperatively, 80% (32/40) of Pug eyes and 82% (28/34) of eyes in the reference population remained sighted.

Conclusions: Comorbidities and complications of cataract surgery in Pugs of this study demonstrate a predisposition for corneal disease. This highlights the importance of preoperative evaluation of factors associated with PK and corneal clarity, and postoperative monitoring for corneal ulceration in this breed.
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http://dx.doi.org/10.1111/vop.12739DOI Listing
May 2020

Modified penetrating keratoplasty with Acell bioscaffold implant in seven horses with deep full-thickness corneal stromal abscess.

Vet Ophthalmol 2017 Jan 3;20(1):46-52. Epub 2016 Feb 3.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.

Objective: To describe and evaluate a modified penetrating keratoplasty technique utilizing ACell for management of equine deep stromal or full-thickness corneal stromal abscesses (SA).

Methods: Cases presenting to the University of Georgia Ophthalmology service for surgical management of SA necessitating penetrating keratoplasty (PK) were included in the study population. Surgery entailed the use of an ACell disk sutured within the deep level of a stepped full-thickness corneal incision with an overlying conjunctival pedicle flap placed in the superficial step incision. Patients were evaluated for success as defined by a comfortable, visual outcome.

Results: Surgery was performed in seven horses. Conjunctival flap incorporation and globe retention occurred in all patients. Functional vision was maintained in six of seven eyes (85.7%) at last follow-up examination (mean of 87.6 days [range 41-251 days]). Mean size of ACell implant was six millimeters (range 4-8 mm). Postoperative complications included moderate to severe anterior uveitis (n = 2), diffuse keratitis (n = 1), incipient cataract formation (n = 3), and anterior and posterior synechiae (n = 1).

Conclusions: This technique is a viable option for treatment of equine SA requiring PK. The use of bioscaffold implant is an alternative to frozen and fresh donor cornea transplantation.
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http://dx.doi.org/10.1111/vop.12349DOI Listing
January 2017

Outcome of conjunctival flap repair for corneal defects with and without an acellular submucosa implant in 73 canine eyes.

Vet Ophthalmol 2015 Mar 22;18(2):116-22. Epub 2014 Jul 22.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, GA, 30602, USA.

Objective: To report and compare the success rate of a conjunctival pedicle flap (CPF) alone vs. a CPF with an underlying acellular submucosa implant for the repair of deep or perforating corneal wounds in dogs.

Procedures: Records of 69 dogs (73 eyes) receiving a CPF with or without an acellular submucosa implant between 2004 and 2012 were reviewed. Successful outcome was defined as a comfortable eye with vision at the last post-operative evaluation. Age, breed, underlying corneal disease, surgical time, lesion characteristics, topical therapies, and postoperative complications were investigated.

Results: Groups consisted of dogs that had a CPF alone (n = 37) and dogs that had a CPF plus an acellular submucosa implant (n = 36). Age, lesion size, surgical time, and time to discontinuation of topical anti-proteolytic medications was not significant between groups. Topical antibiotic use was terminated 13 days sooner (P ≤ 0.01) in dogs with an acellular submucosa implant. The combined success rate of all corneal wounds was 93% with success rate of corneal perforations, descemetoceles, and deep stromal wounds being 89%, 95%, and 100%, respectively. There was no difference in overall success rate between groups. Increasing age was associated with a negative outcome (P ≤ 0.01). Lesion size, presence of a corneal perforation, and concurrent keratoconjunctivitis sicca was not associated with a negative outcome.

Conclusions: A comparable success rate is achieved for deep or perforating corneal wounds stabilized with a CPF alone vs. a CPF plus acellular submucosa. Glaucoma, persistent uveitis, and cataract formation were not reported as post-operative complications in this study population.
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http://dx.doi.org/10.1111/vop.12193DOI Listing
March 2015

Detection of endogenous cortisol in equine tears and blood at rest and after simulated stress.

Vet Ophthalmol 2014 Jul 13;17 Suppl 1:53-60. Epub 2013 Dec 13.

College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA.

Objective: To determine whether cortisol is present in equine tears at rest and during simulated stress and compare tear cortisol to serum free and total cortisol.

Materials And Methods: Fourteen healthy adult horses were included. Paired tear total cortisol and serum total and free cortisol concentrations were measured with ELISA, chemiluminescent immunoassay, and ultrafiltration methodology, respectively, in 10 horses at rest once daily for five consecutive days. In an additional four horses, paired tear and serum samples were collected for cortisol measurement before and after adrenocorticotropic hormone (ACTH) stimulation (cosyntropin, 1 μg/kg IV).

Results: Cortisol was detectable in equine tears at rest. Following ACTH stimulation, tear cortisol increased significantly from baseline at 60-120 min (P ≤ 0.001). Serum total and free cortisol also increased significantly at 30-180 min after ACTH stimulation (P ≤ 0.001). Both serum and tear cortisol returned to baseline concentrations by 360 min. Changes in tear cortisol were similarly associated with changes in serum total and free cortisol, although high tear cortisol concentrations suggest a portion of tear cortisol may be protein-bound.

Discussion: Cortisol is present in equine tears and increases in concert with serum cortisol following ACTH stimulation. Further study is needed to determine whether endogenous cortisol in tears contributes to ocular pathology.
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http://dx.doi.org/10.1111/vop.12128DOI Listing
July 2014

Presence of chelonid fibropapilloma-associated herpesvirus in tumored and non-tumored green turtles, as detected by polymerase chain reaction, in endemic and non-endemic aggregations, Puerto Rico.

Springerplus 2012 17;1:35. Epub 2012 Oct 17.

Department of Pathology, University of Georgia, College of Veterinary Medicine, Athens, GA 30602 USA.

Fibropapillomatosis (FP), a transmissible neoplastic disease of marine turtles characterized by a likely herpesviral primary etiology, has emerged as an important disease in green sea turtles (Chelonia mydas) over the past three decades. The objectives of this study were to determine the suitability of three different chelonid fibropapilloma-associated herpesvirus (CFPHV) gene targets in polymerase chain reaction (PCR) assays of affected tissues; to explore the presence of CFPHV in non-affected skin from turtles with and without tumors; and to better understand tissue localization of the CFPHV genome in a tumor-free turtle by evaluating CFPHV presence in microanatomic tissue sites. Two aggregations of green sea turtles (Chelonia mydas) in Puerto Rico were evaluated, with six sampling intervals over the three-year period 2004-2007. Primary and nested PCR for three different herpesviral gene targets- DNA polymerase, capsid maturation protease, and membrane glycoprotein B- were performed on 201 skin biopsies taken from 126 turtles with and without external tumors. Laser capture microdissection and nested PCR were used to identify tissue localizations of CFPHV in skin from a normal turtle. Of the turtles sampled in Manglar Bay, 30.5% had tumors; at the relatively more pristine Culebrita, 5.3% of turtles sampled had tumors. All three PCR primer combinations successfully amplified CFPHV from tumors, and from normal skin of both tumored and tumor-free turtles. Via nested PCR, the polymerase gene target proved superior to the other two gene targets in the positive detection of CFPHV DNA. CFPHV infection may be common relative to disease incidence, supporting the idea that extrinsic and/or host factors could play a transforming role in tumor expression. Laser capture microdissection revealed CFPHV in skin from a tumor-free turtle, harbored in both epidermal and dermal tissues. Identification of CFPHV harbored in a non-epidermal site (dermis) of a tumor-free turtle indicates that virus is latent in a non-tumored host.
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http://dx.doi.org/10.1186/2193-1801-1-35DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725908PMC
August 2013

Calvarial hyperostosis presenting as unilateral exophthalmos in a female English Springer Spaniel.

Vet Ophthalmol 2012 Jul 22;15(4):263-70. Epub 2011 Dec 22.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.

A 4-month-old intact female English Springer Spaniel presented to the University of Georgia Veterinary Teaching Hospital for evaluation of unilateral, progressive exophthalmos oculus sinister (OS) of 2 weeks' duration. Complete ophthalmic examination revealed moderate OS exophthalmos and lateral globe deviation. No other abnormalities were noted on physical or ophthalmic examination, ocular ultrasound, complete bloodwork, or thoracic radiography. Skull computed tomography (CT) revealed a large, focal, smoothly irregular, cavitated, expansile bony lesion involving the left caudal maxillary and left frontal bones. Biopsies, obtained through a frontal sinusotomy approach to preserve the left globe integrity, demonstrated normal reactive trabecular bone with locally extensive fibrosis. Calvarial hyperostosis was diagnosed based upon appearance on imaging, lesion unilaterality, absence of mandibular involvement, and histopathology. Six months after initial presentation, skull CT was repeated and marked reduction in the degree of frontal bone thickening was demonstrated with complete resolution of cavitations. There was marked clinical improvement with mild, nonpainful exophthalmos, and lateral globe deviation OS on ophthalmic examination. Eleven months after initial presentation, there was complete resolution of the frontal bone lesion with mild thickening of the left calvarial bones on repeat skull CT. There was no exophthalmos or globe deviation present on clinical ophthalmic examination. The proliferative osteopathic lesion was self-resolving with resolution of the exophthalmos and has not recurred to date. To the authors' knowledge, this is the first report of calvarial hyperostosis in a previously unreported breed presenting as unilateral exophthalmos.
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http://dx.doi.org/10.1111/j.1463-5224.2011.00969.xDOI Listing
July 2012

Characterization of cytokines associated with Th17 cells in the eyes of horses with recurrent uveitis.

Vet Ophthalmol 2012 May 7;15(3):145-52. Epub 2011 Oct 7.

Department of Small Animal Medicine and Surgery, The University of Georgia College of Veterinary Medicine, 501 D.W. Brooks Drive, Athens, GA 30602, USA.

Objective: Equine recurrent uveitis (ERU) is a spontaneous disease that is the most common cause of blindness in horses, affecting up to 15% of the horse population. Th17 cells are a major cell population driving the pathogenesis in several mouse models of autoimmune inflammation, including experimental autoimmune uveitis. The purpose of this study is to investigate the role a Th17 cell-mediated response plays in the pathogenesis of ERU.

Procedure: Banked, Davidson's-fixed equine globes histopathologically diagnosed with ERU (n = 7) were compared immunohistochemically with healthy control globes (n = 7). Immunohistochemical staining was performed using a pan-Leptospira antibody and antibodies against IL-6, IL-17, and IL-23. Additionally, immunostaining was performed for T-cell (CD3) and B-cell (CD79α) markers. Specificity of immunoreactivity was confirmed by western blot analysis.

Results: Immunohistochemical staining was positive for IL-6, IL-17, and IL-23 within the cytoplasm of nonpigmented ciliary epithelial cells and mononuclear inflammatory cells infiltrating the iris, and ciliary body of ERU horses (n = 7) but negative in controls (n = 7). ERU-affected eyes were CD3 positive (n = 7) and CD79α negative (n = 7). Staining for Leptospira was negative in all ERU and control globes.

Conclusions: Strong immunoreactivity for IL-6, IL-17, and IL-23, in conjunction with the fact that T lymphocytes are the predominating inflammatory cells present in ERU, suggests that IL-17-secreting helper T-cells play a role in the pathogenesis of ERU. These findings suggest that horses with ERU may serve as a naturally occurring animal model for autoimmune uveitis.
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http://dx.doi.org/10.1111/j.1463-5224.2011.00951.xDOI Listing
May 2012

Concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci.

Vet Ophthalmol 2012 Mar 15;15(2):81-5. Epub 2011 Sep 15.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.

Objective: To report concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci and to document any correlation with equine recurrent uveitis (ERU).

Procedure: Records of 131 horses (241 eyes) examined at the University of Georgia Veterinary Teaching hospital from 2001 to 2010 were reviewed with either clinically normal fundi or depigmented punctate chorioretinal foci in the absence of other fundic pathology. Data collected included patient signalment, concurrent clinical ocular findings and follow-up information. Sex, presence of no other intraocular findings, presence of ERU, presence of cataracts, and presence of vitreal disease were compared between normal and foci groups using chi-squared analysis. Age and length of follow-up time were compared using a student's t-test.

Results: Ninety-one horses (167 eyes) with chorioretinal foci and forty horses (74 eyes) with clinically normal ocular fundi were examined. Fifty-eight (64%) horses with chorioretinal foci and 20 (50%) horses with clinically normal fundi had a normal intraocular examination. There was no significant difference in any of the criteria examined between groups.

Conclusions: Horses with depigmented punctate chorioretinal foci, in the absence of other fundic pathology, are not more likely to have intraocular disease or ERU than horses with clinically normal ocular fundi. These findings suggest that depigmented punctate fundic foci in horses are not indicative of or associated with ERU.
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http://dx.doi.org/10.1111/j.1463-5224.2011.00940.xDOI Listing
March 2012

Clinicopathologic findings in a dog with a retrobulbar meningioma.

J Vet Diagn Invest 2011 Jul 13;23(4):857-62. Epub 2011 Jun 13.

Department of Small Animal Medicine, College of Veterinary Medicine, The University of Georgia, 501 D.W. Brooks Drive, Athens, GA 30602, USA.

An 11-year-old Fox Terrier dog was evaluated for a 10-month history of progressive exophthalmia and visual deficits in the right eye. Ophthalmologic examination revealed severe corneal fibrosis and pigmentation, which obscured examination of the anterior chamber of the right eye. There was decreased retropulsion of the right eye. Neurological examination revealed an absent menace response bilaterally. Pupillary light reflex was normal in the left eye. Due to the corneal pathology, pupillary light reflex was unable to be evaluated in the right eye. A retrobulbar mass with heterogeneous echotexture was identified using ultrasonography. Cytological evaluation of a fine-needle aspirate of the mass disclosed a neoplastic cell population consisting of round to polygonal cells with lightly basophilic to gray cytoplasm and round to ovoid nuclei having a coarse granular chromatin pattern. Magnetic resonance imaging disclosed a right-sided retrobulbar mass that extended through the optic canal and was contiguous with an extra-axial mass in the ventral right rostral and middle cranial fossae. The mass displayed homogenous and strong contrast enhancement. Following exenteration, histological examination of the retrobulbar mass was consistent with meningioma. Immunohistochemically, tumor cells stained positive for vimentin (cytoplasmic) and E-cadherin (membranous), and negative for S100, pancytokeratin, and cytokeratins AE1 and AE3.
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http://dx.doi.org/10.1177/1040638711408280DOI Listing
July 2011

Long-term effects of epidural analgesia in labor: a randomized controlled trial comparing high dose with two mobile techniques.

Birth 2011 Jun 10;38(2):105-10. Epub 2011 Mar 10.

Department of Anaesthesia at the Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield.

Background: Epidural analgesia provides the most effective pain relief in labor, but it is not known if it causes adverse long-term effects. The objective of this study was to assess the long-term effects of two mobile epidural techniques relative to high-dose epidural analgesia in a randomized controlled trial.

Methods: A total of 1,054 nulliparous women were randomized to traditional high-dose epidural, combined spinal epidural, or low-dose infusion. Women in all groups were followed-up at 12 months postpartum by postal questionnaire to assess long-term symptoms. The primary long-term outcome was backache occurring within 3 months of the birth persisting for longer than 6 weeks. Secondary outcomes were frequent headaches and fecal and urinary stress incontinence.

Results: No significant differences were found in long-term backache after combined spinal epidural or low-dose infusion relative to high-dose epidural. Significantly less headache occurred in combined spinal epidural analgesia than high-dose epidural (OR: 0.57, 95% CI: 0.36-0.92), but no difference was found for low-dose infusion. Significantly less fecal incontinence (OR: 0.51, 95% CI: 0.30-0.87) and stress incontinence (OR: 0.65, 95% CI: 0.42-1.00) occurred with low-dose infusion.

Conclusion: Trial evidence showed no long-term disadvantages and possible benefits of low-dose mobile relative to high-dose epidural analgesia.
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http://dx.doi.org/10.1111/j.1523-536X.2010.00466.xDOI Listing
June 2011

Immunohistochemical study of matrix metalloproteinases-2 and -9, macrophage inflammatory protein-2 and tissue inhibitors of matrix metalloproteinases-1 and -2 in normal, purulonecrotic and fungal infected equine corneas.

Vet Ophthalmol 2010 Mar;13(2):81-90

Department of Pathology, College of Veterinary Medicine, The University of Georgia, Athens, GA 30602, USA.

Objective: Determine the effects of matrix metalloproteinases (MMPs)-2, -9, macrophage inflammatory protein-2 (MIP-2), tissue inhibitors of matrix metalloproteinase (TIMP)-1 and -2 by immunohistochemical expression in fungal affected and purulonecrotic corneas.

Procedure: Paraffin-embedded equine corneal samples; normal (n = 9), fungal affected (FA; n = 26), and purulonecrotic without fungi (PN; n = 41) were evaluated immunohistochemically for MMP-2, -9, MIP-2, TIMP-1 and -2. The number of immunoreactive inflammatory cells was counted and statistics analyzed. Western blot was performed to detect MMP-2, MMP-9, TIMP-1 and TIMP-2 proteins.

Results: Matrix metalloproteinases-2, -9, MIP-2, TIMP-1 and -2 immunoreactivity was identified in corneal epithelium of normal corneas, and in corneal epithelium, inflammatory cells, keratocytes, and vascular endothelial cells of both FA and PN samples. Inflammatory cell immunoreactivity was significantly higher in FA and PN samples than in the normal corneas. There was positive correlation between MMP-2 and MIP-2, MMP-9 and MIP-2, and MMP-9 and TIMP-1 in inflammatory cell immunoreactivity in FA samples. There was positive correlation between MMP-9 and MIP-2, MMP-9 and TIMP-2, MIP-2 and TIMP-1, and MIP-2 and TIMP-2 in inflammatory cell immunoreactivity in PN samples. Western blot confirmed the presence of all four proteins in equine corneal samples.

Conclusion: Increased immunoreactivity of MMP-2 and -9 in FA and PN samples is indirectly related to MIP-2 through its role in neutrophil chemo-attraction. Tissue inhibitors of matrix metalloproteinase-1 and TIMP-2 are up-regulated in equine purulonecrotic and fungal keratitis secondary to MMP-2 and MMP-9 expression. The correlation between MMPs -2 and -9, MIP-2, TIMPs -1 and -2 suggests that these proteins play a specific role in the pathogenesis of equine fungal keratitis.
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http://dx.doi.org/10.1111/j.1463-5224.2009.00757.xDOI Listing
March 2010

Identification of ocular matrix metalloproteinases present within the aqueous humor and iridocorneal drainage angle tissue of normal and glaucomatous canine eyes.

Vet Ophthalmol 2007 Nov-Dec;10 Suppl 1:108-16

Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA 30602, USA.

Purpose: The purpose of this study was to identify the most active matrix metalloproteinases (MMP) within the aqueous humor and iridocorneal angle tissue involved in the normal canine eye, and to compare these results to the MMP activity in dogs with glaucoma.

Animal Studied: Aqueous humor samples from 32 normal eyes and 26 glaucomatous eyes were obtained through aqueous centesis and analyzed for MMP activity. Iridocorneal angle tissue from 16 enucleated normal canine eyes and 5 enucleated glaucomatous eyes were dissected and homogenized into solution.

Procedure: Bradford total protein assays were determined for aqueous humor samples and iridocorneal angle tissue samples. Substrate gelatin zymography was performed using 0.2 microL volumes of an MMP-2/MMP-9 control, 2 microL volumes of aqueous humor samples, and 10 microg weights of total protein from iridocorneal angle tissue. The presence of MMP gel bands were identified visually and measured quantitatively by densitometry technique. A statistical analysis was performed on the data using Student's t-test, multiple logistic Wald's chi-squared regression, Pearson correlations, and repeated measures analysis.

Results: Within the aqueous humor of canine eyes, MMP-2 latent form was found to be the most relevant MMP. The quantity of latent MMP-2 within the aqueous humor of the glaucoma samples was significantly increased compared to the normal aqueous samples (P < 0.0001). Glaucoma occurrence was associated with elevated aqueous humor latent MMP-2 (P = 0.0002). Within the canine iridocorneal angle tissue, MMP-9 latent form and MMP-2 active form were found to be the most relevant MMPs. MMP-2 active form was found to be significantly increased in the glaucoma tissue samples when compared to the normal tissue samples (P = 0.0044). MMP-9 latent form was also found to be significantly increased in glaucomatous tissue when compared to the normal eyes (P = 0.0002). Tissue MMP-9 latent form was found to be associated with glaucoma status (P = 0.042).

Conclusion: Glaucoma aqueous humor samples expressed a statistically increased latent MMP-2 when compared to normal eyes. Iridocorneal angle tissue from glaucomatous eyes expressed a statistically significant increase in active MMP-2 and latent MMP-9 when compared to normal eyes. These data demonstrate that there is an association between elevated levels of intraocular MMP-2 and MMP-9 and the presence of glaucoma.
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http://dx.doi.org/10.1111/j.1463-5224.2007.00586.xDOI Listing
January 2008

Adaptations of subpalpebral lavage systems used for llamas (Lama glama) and a harbor seal (Phoca vitulina).

J Zoo Wildl Med 2007 Sep;38(3):453-9

Lion Country Safari, 2003 Lion Country Safari Road, Loxahatchee, Florida 33470, USA.

Subpalpebral lavage systems (SPLSs) were adapted for use in zoo llamas (Lama glama) and a wild harbor seal (Phoca vitulina) during therapy for severe ulcerative keratitis or corneal perforation. One llama presented with a melting corneal ulcer caused by Pseudomonas aeruginosa, which necessitated frequent application of a topical ophthalmic antibiotic. The lavage system was used routinely during the day and was connected to a balloon infusion system at night to allow for continuous medication administration. The ulcer healed soon after therapy was extended to include overnight treatment with the infusion system. A SPLS system was also combined with a balloon infusor during postoperative treatment of a second llama that had sustained a corneal perforation. Both llamas tolerated the infusor/lavage systems well and regained vision. One llama had minor conjunctival irritation from the SPLS that resolved quickly without treatment. Bilateral SPLS were placed in a wild harbor seal for treatment of severe ulcerative keratitis associated with Candida albicans infection. The seal tolerated the lavage systems well throughout 14 wk of their use in an aquatic environment with other seals. Partial detachment of the lavage systems from the skin of the seal occurred a few times during treatment and was easily corrected. Severe keratitis resolved with administration of antimicrobials through the lavage systems, and the seal was returned to the wild. The use of SPLSs alone or in ombination with balloon infusion systems warrants consideration for exotic, wild, and aquatic animals that cannot tolerate repetitive manual applications of topical ophthalmic medication.
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http://dx.doi.org/10.1638/2006-0065.1DOI Listing
September 2007

Effects of human recombinant alpha-2b interferon and feline recombinant omega interferon on in vitro replication of feline herpesvirus-1.

Am J Vet Res 2006 Aug;67(8):1406-11

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, 30602, USA.

Objective: To evaluate the effects of recombinant human interferon alpha-2b (rHuIFN-alpha2b) and recombinant feline interferon omega (rFeIFN-omega) on in vitro replication of feline herpesvirus (FHV)-1.

Sample Population: Cultures of Crandell-Rees feline kidney (CRFK) cells.

Procedures: CRFK cells were treated with rFeIFN-omega or rHuIFN-alpha2b at concentrations ranging from 100 to 500,000 U/mL. Cultures were then inoculated with FHV-1. Constant concentrations of interferon products were maintained throughout the study. Reductions in the number and size of plaques were used as indicators of antiviral activity. Six plaque reduction assays were performed in duplicate. A 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide assay was used to detect cytotoxic effects of interferon. A 1-way ANOVA and Dunnett test were used to determine significant differences.

Results: Treatment with rFeIFN-omega at various concentrations resulted in significant reductions in the number of plaques (100,000 U/mL, 54.7%; and 500,000 U/mL, 59.8%) and in plaque size (100,000 U/mL, 47.5%; 250,000 U/mL, 81.0%; and 500,000 U/mL; 70.5%). Treatment with various concentrations of rHuIFN-alpha2b resulted in a significant reduction in plaque size (100,000 U/mL, 56.0%; 250,000 U/mL, 75.7%; and 500,000 U/mL, 69.0%). None of the tested concentrations of interferon caused significant cellular toxicosis.

Conclusions And Clinical Relevance: At some of the higher concentrations, the antiviral effect of rFeIFN-omega was greater than the antiviral effect of rHuIFN-alpha2b. Reduction in plaque size appeared to be a good indicator of the antiviral activity of interferon against FHV-1.
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http://dx.doi.org/10.2460/ajvr.67.8.1406DOI Listing
August 2006

In vitro efficacy of a buffered chelating solution as an antimicrobial potentiator for antifungal drugs against fungal pathogens obtained from horses with mycotic keratitis.

Am J Vet Res 2006 Apr;67(4):562-8

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.

Objective: To determine whether a novel third-generation chelating agent (8 mM disodium EDTA dehydrate and 20 mM 2-amino-2-hydroxymethyl-1, 3-propanediol) would act as an antimicrobial potentiator to enhance in vitro activity of antifungal medications against fungal isolates obtained from horses with mycotic keratitis.

Sample Population: Fungal isolates (3 Aspergillus isolates, 5 Fusarium isolates, 1 Penicillium isolate, 1 Cladosporium isolate, and 1 Curvularia isolate) obtained from horses with mycotic keratitis and 2 quality-control strains obtained from the American Type Culture Collection (ATCC; Candida albicans ATCC 90028 and Paecilomyces variotii ATCC 36257).

Procedure: Minimum inhibitory concentrations (MICs) against fungal isolates for 4 antifungal drugs (miconazole, ketoconazole, itraconazole, and natamycin) were compared with MICs against fungal isolates for the combinations of each of the 4 antifungal drugs and the chelating agent. The Clinical and Laboratory Standards Institute microdilution assay method was performed by use of reference-grade antifungal powders against the fungal isolates and quality-control strains of fungi.

Results: Values for the MIC at which the antifungal drugs decreased the growth of an organism by 50% (MIC50) and 90% (MIC90) were decreased for the control strains and ophthalmic fungal isolates by 50% to 100% when the drugs were used in combination with the chelating agent at a concentration of up to 540 microg/mL.

Conclusions And Clinical Relevance: The chelating agent increased in vitro activity of antifungal drugs against common fungal pathogens isolated from eyes of horses with mycotic keratitis.
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http://dx.doi.org/10.2460/ajvr.67.4.562DOI Listing
April 2006

Effects of treatment with and without adjuvant radiation therapy on recurrence of ocular and adnexal squamous cell carcinoma in horses: 157 cases (1985-2002).

J Am Vet Med Assoc 2004 Dec;225(11):1733-8

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7371, USA.

Objective: To determine the effects of treatment with and without adjuvant radiation therapy on recurrence of ocular and adnexal squamous cell carcinoma (SCC) at specific anatomic locations in horses.

Design: Retrospective study.

Animals: 91 horses.

Procedures: Medical records of horses with histologically confirmed ocular and adnexal SCC evaluated from 1985 to 2002 were reviewed. Sex, breed, age, type of treatment, location, and recurrence of SCC were recorded. Two treatment groups determined by recurrence of SCCs treated with and without adjuvant radiation therapy were established.

Results: The anatomic site with the highest recurrence rate was the limbus (junction of the cornea and sclera) or bulbar conjunctiva (477%), independent of treatment group. There was a significant difference in recurrence rates of ocular and adnexal SCCs between the 2 treatment groups, independent of anatomic location. Recurrence rates of SCCs treated with and without adjuvant radiation therapy were 11.9% and 44.1%, respectively. Recurrence rates for SCCs of the eyelid, limbus or bulbar conjunctiva, and cornea treated with adjuvant radiation therapy were significantly different from those for SCCs treated without adjuvant radiation therapy. The most frequently represented anatomic site for ocular and adnexal SCCs was the eyelid (28.7%). Coat color, breed, and the interaction of age and breed had a significant effect on tumor recurrence regardless of treatment type and anatomic location.

Conclusions And Clinical Relevance: Results indicated that ocular and adnexal SCCs treated with adjuvant radiation therapy had a significantly lower recurrence rate, compared with SCCs treated without adjuvant radiation therapy, independent of anatomic location.
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http://dx.doi.org/10.2460/javma.2004.225.1733DOI Listing
December 2004

Clinical resolution of Brucella canis-induced ocular inflammation in a dog.

J Am Vet Med Assoc 2004 Jun;224(11):1804-7, 1788-9

Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30605, USA.

A 2-year-old spayed female mixed-breed dog was referred with an 8-month history of recurrent bilateral anterior uveitis and hyphema secondary to infection with Brucella canis. Treatment with doxycycline PO and atropine and prednisone acetate topically prior to referral had failed to resolve the ocular inflammation. Successful control of ocular inflammation was achieved after initiation of treatment with gentamicin SC and ciprofloxacin and doxycycline PO. The finite indirect fluorescent antibody (IFA) titer was reduced by half, and results of an agar gel immunodiffusion (AGID) test became negative after rifampin was added to the treatment protocol. Treatment with gentamicin was eventually discontinued because of evidence of renal toxicosis and cutaneous reactions to repeated injections. Thirty-five months after initial examination of the dog, results of the AGID test were still negative, the finite IFA titer was stable, and ocular inflammation had resolved, suggesting that the ocular infection may have been eliminated. To our knowledge, this represents the first report of the successful treatment of ocular inflammation caused by B canis infection in a dog.
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http://dx.doi.org/10.2460/javma.2004.224.1804DOI Listing
June 2004

Effects of transcorneal iridal photocoagulation on the canine corneal endothelium using a diode laser.

Vet Ophthalmol 2003 Sep;6(3):197-203

Department of Small Animal Medicine, College of Veterinary Medicine, Department of Statistics, University of Georgia, 501 DW Brooks Dr, Athens, GA 30602, USA.

Objective: To investigate the potential damage to the canine corneal endothelium following transcorneal iridal laser photocoagulation using a semiconductor diode laser.

Animals Studied: Sixteen young mongrel dogs.

Procedures: Baseline corneal endothelial cell counts and corneal thickness were measured in the central and temporal quadrants using a noncontact specular microscope under general anesthesia. Transcorneal iridal photocoagulation was applied using a semiconductor diode laser in a continuous mode with the use of an operating microscope. Fifteen dogs were treated, and the sixteenth dog served as a control. Fifteen different treatment combinations were randomly assigned to the 30 eyes; the fellow eye was treated differently. Three treatment factors were investigated: (1) laser energy intensity, (2) target tissue to endothelial distance, and (3) laser application duration. After 3 weeks the dogs were euthanized, specular microscopy was repeated, and the cornea was examined by scanning electron microscopy.

Results: Dyscoria and focal iris darkening were noted in all eyes immediately following laser treatment. Focal corneal edema (n = 2) and an incipient anterior capsular cataract (n = 1) were also noted. Baseline mean corneal endothelial cell densities were 2530 cells/mm2 centrally and 2607 cells/mm2 temporally. Postlaser corneal endothelial cell densities were 2499 cells/mm2 centrally and 2523 cells/mm2 temporally. Mean prelaser corneal thickness measurements were 0.555 mm centrally and 0.549 mm temporally. Postlaser corneal thickness measurements were 0.580 mm centrally and 0.554 mm temporally. Statistical analyzes revealed no significant changes in endothelial cell densities (P > 0.05) or corneal thickness (P > 0.05) induced by any treatment combination. Aside from tissue handling and processing artifacts, scanning electron microscopy revealed no endothelial cell damage.

Conclusions: Our study demonstrated by specular and scanning electron microscopy that diode laser iridal photocoagulation had no significant effect on the canine corneal endothelium within the parameters described. However, one must take into consideration the young age of the dogs and the potential for corneal endothelial cell regeneration in young dogs, and the relatively short period of postoperative study.
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http://dx.doi.org/10.1046/j.1463-5224.2003.00294.xDOI Listing
September 2003

Use of a caudal auricular axial pattern flap in three cats and one dog following orbital exenteration.

Vet Ophthalmol 2003 Jun;6(2):121-6

Purdue University School of Veterinary Medicine, West Lafayette, IN 47907, USA.

Orbital exenteration accompanied by wide eyelid excision in the cat and dog may leave a defect that cannot be closed in a primary fashion. This report describes the use of a caudal auricular axial pattern flap to effect closure following orbital exenteration in three cats and one dog. The most common complication was distal flap necrosis, which necessitated a second surgery in two patients.
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http://dx.doi.org/10.1046/j.1463-5224.2003.00275.xDOI Listing
June 2003

Effects of the calcium channel antagonist amlodipine in cats with surgically induced hypertensive renal insufficiency.

Am J Vet Res 2002 Jun;63(6):833-9

Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens 30605, USA.

Objective: To determine whether amlodipine besylate decreases systemic arterial blood pressure (BP) and reduces the prevalence of complications in cats with induced hypertensive renal insufficiency.

Animals: 20 cats with partial nephrectomy.

Procedure: Following reduction in renal mass, 10 cats were administered 0.25 mg of amlodipine/kg, PO, q 24 h (group A). Ten cats served as a control group (group C). Systolic BP (SBP), diastolic BP (DBP), and mean BP (MBP), physical activity, and pulse rate were measured continuously for 36 days by use of radiotelemetric devices.

Results: Compared with values for clinically normal cats, SBP, DBP, and MBP were significantly increased in cats of group C. Cats in group A had significant reductions in SBP, DBP, and MBP, compared with values for cats in group C. Albuminuria but not urine protein-to-creatinine ratio was significantly correlated (R2 = 0.317) with SBP in hypertensive cats. Prevalence of ocular lesions attributable to systemic hypertension in group C (7 cats) was greater than that observed in group A (2). Two cats in group C were euthanatized on day 16 because of nuerologic complications attributed to systemic hypertension. One normotensive cat in group A was euthanatized because of purulent enteritis of unknown cause on day 27.

Conclusions And Clinical Relevance: Amlodipine had an antihypertensive effect in cats with coexistent systemic hypertension and renal insufficiency. Its use may improve the prognosis for cats with systemic hypertension by decreasing the risk of ocular injury or neurologic complications induced by high BP.
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http://dx.doi.org/10.2460/ajvr.2002.63.833DOI Listing
June 2002
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