Abstract
ObjectiveTo describe ultrasonography as a diagnostic method of in vivo Descemet's membrane detachment (DMD) in horses. Animals studied: Seven horses (three Icelandic horses, two Dutch Warmblood horses, one Appaloosa, and one Welsh Pony), presenting with moderate‐to‐severe focal or diffuse corneal edema, in whom DMD was suspected on ultrasonographic examination and confirmed with histopathology, were studied.ProcedureA retrospective analysis of case records of horses with suspected DMD was performed.ResultsMedian age at presentation was 14 years (range 11‐24). Clinical signs in eyes with DMD were unilateral in all horses and included blepharospasm and epiphora (6/7), buphthalmos (5/7), moderate‐to‐severe focal or diffuse corneal edema (7/7), corneal epithelial bullae (4/7), corneal neovascularization (4/7), Haab's striae (2/7), corneal endothelial precipitates (1/7), fibrin in the anterior chamber (1/7), focal cataract (2/7), and pigment deposits on the anterior lens capsule (1/7). During transpalpebral ultrasonography, a distinct linear echogenic structure was noted in the anterior chamber, initially diverging from, and later running parallel to, the posterior lining of the cornea in all eyes studied. In all cases, the cornea was severely thickened and echogenic, consistent with edema, and DMD was suspected. In all horses, the clinical signs progressed and the affected eye was eventually enucleated. Histopathology revealed DMD (7/7), spindle cell proliferation (4/7), Descemet's membrane reformation (3/7), and inflammation of the anterior uvea (5/7). Overall incidence was 1.04%.ConclusionsUltrasonography is an adequate tool in diagnosing DMD in horses. Descemet's membrane detachment should be included in the differential diagnosis in horses with dense focal or diffuse corneal edema.
Highlights
Descemet's membrane (DM) is the basement membrane produced by the corneal endothelium
Nine horses were identified with suspected DM detachment (DMD) on ultrasonography, and two cases were excluded from this study as histopathology was not available
During the time of the study, 671 new ophthalmic cases were presented to the Equine Department, making the overall incidence 1.04% (7/671) for all confirmed DMD cases and 1.34% (9/671) for confirmed and suspected cases combined
Summary
Descemet's membrane (DM) is the basement membrane produced by the corneal endothelium. Other diagnostic procedures have been recommended, including ultrasound biomicroscopy (UBM), specular and confocal microscopy, and anterior segment optical coherence tomography (OCT).[5,12,13,14,15,16] As described in literature, DMD in horses has been diagnosed intraoperatively, ultrasonographically,[11] and on histopathology.[8,11] In one study, corneal spectral domain optical coherence tomography (SD‐OCT) revealed a partial detachment of DM and associated endothelium floating in the anterior chamber, in a horse with heterochromic iridocyclitis and secondary keratitis.[17] To the authors’ knowledge, only one study reports ultrasonographic findings of a DMD in a horse.[11] In this case, the DMD resolved, and no histopathology was performed that could confirm the diagnosis. The purpose of our study was to describe ultrasonographic findings of DMD in horses confirmed by histopathology
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