Superficial keratitis

Re: Superficial keratitis

Gareth C. — Thu, 15 Jan 2015 19:55:11 GMT

Check the diagnosis of the cause, pannus likely but also check for kcs, blink reflex, episcleritis etc. If is pannus then if optimmune works stick with it as is safe long term. You can add in pred forte when needed, eg sunny summer weeks or as an adjunct regularly. Some greyhounds are quite bugveyed so check exposure too and possibly add in some lubricatiin

Re: Superficial keratitis

Karen Eggleton — Wed, 14 Jan 2015 12:47:34 GMT

Thanks all! MSD have sent me a clinical aper about using Optimmune vs 0.1% dex tid. There appears to be equal clinical efficacy. Any comments on preference? am currently using 1% Pred topically. Should I be swapping perhaps?

Re: Superficial keratitis

fluffygirl — Sun, 11 Jan 2015 19:45:42 GMT

A photo might be helpful if you can manage it!

Re: Superficial keratitis

Yantha Smyth — Sun, 11 Jan 2015 14:50:55 GMT

greyhounds seem to commonly get pannus, and i think optimmune can actually help with the pigmentation too

Re: Superficial keratitis

John Flynn — Sun, 11 Jan 2015 14:05:10 GMT

[quote user="nobbygonzo"]Anything for reducing the pigmentation.[/quote]

I've read about some folks using cryotherapy for this, but the pigment will return unless the underlying disease is well controlled and there's an absence of detailed clinical data on this technique with follow-up. Never done it myself. See ref below:

Adjunctive cryotherapy for pigmentary keratitis in dogs: a study of 16 corneas.

Vet Ophthalmol. July 2014;17(4):241-9.

Thierry Azoulay

OBJECTIVE: To assess whether soft cryotherapy (dimethylether, isobutene, and propane) can remove pigmentation of the cornea that has accumulated under different conditions when conventional therapy has been unsuccessful. ANIMALS STUDIED: Nine dogs with unilateral or bilateral corneal pigmentation (16 eyes) were included based on progressive corneal pigmentation that was unresponsive to long-term etiological treatment. The dogs had keratoconjunctivitis sicca or chronic superficial keratitis. PROCEDURES: A cryogen of 95% dimethylether, 3% isobutane, and 2% propane was applied to the pigmented areas of each cornea under anesthesia. Initial corneal pigmentation and changes were documented over the entire study period using a grading scheme and clinical photographs. RESULTS: Most of the pigment deposits were gone by 5-15 days after cryosurgery. Postoperatively, the dogs showed some corneal edema and corneo-conjunctival inflammation, and three dogs had superficial corneal ulcers; these symptoms had resolved by 1 month after the procedure. Follow-up for more than 90 days was available in five dogs (nine corneas), and we observed total or partial repigmentation when the underlying disease was not controlled. A new cryotherapy procedure was successfully performed in two of these dogs. CONCLUSIONS: Given the sensitivity to cold of melanocytes, cryotherapy is a viable adjunctive treatment for refractory severe corneal pigmentation. Etiological treatment remains necessary to prevent pigmentation from rapidly reappearing. Only a few dogs were followed for more than 90 days; further study is necessary to evaluate the long-term safety and efficacy of soft cryotherapy.

Re: Superficial keratitis

Lindsey Edwards — Sun, 11 Jan 2015 13:08:29 GMT

Is there evidence of pannus formation? Optimmune or tactolimus should be effective