Spontaneous Chronic Corneal Epithelial Defects Research Articles

Superficial keratectomy for the treatment of spontaneous chronic corneal epithelial defects in dogs.

To report the outcome of superficial keratectomy with bandage contact lens placement for the treatment of spontaneous chronic corneal epithelial defects (SCCEDs) in dogs. Patients that underwent a superficial keratectomy with bandage lens placement for the treatment of one or more SCCEDs were retrospectively included in the study. Signalment, eye(s) affected, prior medical therapy and any procedures performed, post-operative medical therapy, healing rate, and any post-operative complications were recorded. Superficial keratectomy was performed to approximately one-fifth of corneal depth under operating microscope guidance and a bandage lens was placed immediately post-operatively. Corneas were considered healed when the fluorescein stain was negative. One hundred and seven dogs met the inclusion criteria with 121 SCCEDs. The mean age of patients was 8.34 ± 2.89 years (1-15). Ninety-nine percent (120/121) of SCCEDS healed with no additional treatment within 21 days of surgery. One eye had a diamond burr debridement performed on Day 14 post-operatively and healed 2 weeks following the additional procedure. No post-operative complications were noted. This study found superficial keratectomy with bandage lens placement to be an effective treatment for SCCEDs.

Treatment of canine spontaneous chronic corneal epithelial defects (SCCEDs) with corneal thermal cautery: A retrospective study of 89 cases.

To evaluate the clinical course and outcome of canine spontaneous chronic corneal epithelial defects (SCCEDs) treated with a combination of cotton-tip epithelial debridement (ED) and corneal thermal cautery (CTC), with or without diamond burr debridement (DBD). Retrospective medical record review was used to identify dogs treated for SCCEDs at the Veterinary School of Toulouse between 2001 and 2021. The variables identified included signalment, history, clinical findings, previous treatments, and outcomes. Surgery was performed under manual restraint after topical anesthesia of the cornea. The outcome endpoints included healing, clearing of the cornea and complications. Seventy-seven dogs (89 eyes) from 28 different breeds fulfilled the inclusion criteria. The mean age was 8.78 years. The overall success rate after one procedure was 65.1% with a mean healing time of 15.4 days, but 21 eyes lost to follow-up after the initial treatment, were not included in calculations. There was no significant effect of age, eye, brachycephalic conformation and previous treatments. No significant differences in healing rates were found between groups that received DBD or not. Fifteen eyes (22.7%) underwent a second procedure. Complications (corneal pigmentation, uveitis, corneal bullae, and corneal infection) were observed in 15 cases (22%), with only two cases of complicating melting ulcer. CTC is a safe and effective treatment for SCCEDs in dogs and can be performed without general anesthesia. Additional DBD does not bring any significant value to CTC in SCCEDs. CTC could be interesting in cases where other procedures are less desirable.

Breed distribution of spontaneous chronic corneal epithelial defectsin UK dogs.

This study aimed to assess the risk of bilateral disease in dogs affected by spontaneous chronic corneal epithelial defects(SCCEDs) and identify any recent changes in the distribution of breeds affected. Medical records of dogs assessed at a single ophthalmic centre for the management of SCCEDs between 2007 and 2020 were reviewed, and clinical data were extracted. Three hundred and seven dogs met the inclusion criteria. Boxers (129 dogs), Staffordshire Bull Terriers (37 dogs) and French Bulldogs (20 dogs) were most frequently affected. Overall, the median age at presentation was 8 years (range 1-15 years), but French Bulldogs had a younger median age of 6 years. Boxers, French Bulldogs and Staffordshire Bull Terriers showed higher odds of bilateral ulceration (odds ratio 1.79, 1.65 and 1.64, respectively) compared to the overall study population. The median time between presentations when both eyes were affected was 4 months (range 0-42 months). There was a statistically significant increase inFrench Bulldogs, a reduction in Boxers and a stable number of Staffordshire Bull Terriers treated for this condition. However, as the effective sample size from each individual breed was small, further studies would be beneficial to confirm these findings. The results from this study suggest a shift in breed distribution. The risk of bilateral disease is higher in the three breeds reported here, and owners should be counselled appropriately at the initial examination.

Effect of topical non-steroidal anti-inflammatory drugs on healing times and complications in dogs with spontaneous chronic corneal epithelial defects.

Little is published regarding topical NSAID effect on corneal healing in dogs. This retrospective cohort study aimed to compare healing times and complications in dogs with spontaneous chronic corneal epithelial defects (SCCED) treated with and without topical non-steroidal anti-inflammatory drugs (NSAID). Medical records of 66 dogs (71 eyes) diagnosed with SCCED between 2008 and 2019 were included. Eyes were divided into: (1) those receiving topical NSAIDs (n=33) versus (2) those not receiving topical NSAID (n=38). Follow-up until healed, such as comfortable eye, negative fluorescein stain was required. Use of topical or systemic anti-inflammatories outside of NSAID or presence of ocular disorders or systemic endocrinopathies that may contribute to delayed healing resulted in study exclusion. Healing times were significantly longer in eyes that received topical NSAID (p=0.008), however, the use of more topical medications for treatment was also associated with longer healing times (p=0.001). The majority of eyes in the NSAID group received multiple medications, compared to the non-NSAID group, so it was not possible to separate the effects of NSAID from a number of medications. Complications occurred in three eyes of three dogs within the NSAID group. In these canine SCCED eyes, the use of more topical medications, including NSAID, was associated with significantly delayed healing time.

Use of autologous serum or Vizoovet to improve healing rates of spontaneous chronic corneal epithelial defects after diamond burr debridement in dogs.

To determine whether the use of autologous serum or Vizoovet® improved healing rates of spontaneous chronic corneal epithelial defects (SCCEDs) after diamond burr debridement (DBD) in dogs. Two parallel group randomized prospective study with a historical control group. Canine patients having undergone DBD for treatment of SCCEDs were included. Data for the control group (ofloxacin only) were gathered from patient records. Patients were randomly assigned to treatment groups for post-procedural medical treatments of ofloxacin and autologous serum (group 1) or ofloxacin and Vizoovet®, an all-natural eyed drop containing propolis, aloe vera, and chamomile (group 2). Each dog was examined between 2 and 3weeks until the cornea was fluorescein stain negative. Data points collected included age, sex, breed, type of medications used, retention of bandage contact lens (BCL), time to healing, and number of DBD performed. A total of 120 dogs, each contributing one eye to the study, underwent DBD for SCCEDs. Mean (± standard deviation) days until healed were 20.1±11.1days, 16.3±4.5days, and 16.0±3.7days for the control group, group 1, and group 2, respectively. There was a marginally significant difference in days until healed between groups (p=.0515). SCCEDs healed significantly faster in group 2 (p=.03) and marginally faster in group 1 (p=.06) compared with the control group. Days until healing between group 1 and 2 were not significantly different (p=.76). As compared to the control group, use of Vizoovet® as adjunctive medical treatment resulted in shorter corneal healing time after DBD.

A defect in the NOG gene increases susceptibility to spontaneous superficial chronic corneal epithelial defects (SCCED) in boxer dogs

BackgroundSuperficial chronic corneal epithelial defects (SCCEDs) are spontaneous corneal defects in dogs that share many clinical and pathologic characteristics to recurrent corneal erosions (RCE) in humans. Boxer dogs are predisposed to SCCEDs, therefore a search for a genetic defect was performed to explain this susceptibility. DNA was extracted from blood collected from Boxer dogs with and without SCCEDs followed by whole genome sequencing (WGS). RNA sequencing of corneal tissue and immunostaining of corneal sections from affected SCCED Boxer dogs with a deletion in the NOG gene and affected non-Boxer dogs without the deletion were performed.ResultsA 30 base pair deletion at a splice site in Noggin (NOG) (Chr 9:31453999) was identified by WGS and was significantly associated (P < 0.0001) with Boxer SCCEDs compared to unaffected non-Boxer dogs. NOG, BMP4, MMP13, and NCAM1 all had significant fold reductions in expression and SHH was significantly increased in Boxers with the NOG deletion as identified by RNA-Seq. Corneal IHC from NOG deletion dogs with SCCEDs had lower NOG and significantly higher scores of BMP2.ConclusionsMany Boxer dogs with SCCED have a genetic defect in NOG. NOG is a constitutive protein in the cornea which is a potent inhibitor of BMP, which likely regulate limbal epithelial progenitor cells (LEPC). Dysregulation of LEPC may play a role in the pathogenesis of RCE.

Cotton-tip debridement, scalpel blade debridement, and superficial grid keratotomy for treatment of spontaneous chronic corneal epithelial defects (SCCED): A retrospective evaluation of 308 cases.

To evaluate the clinical course and outcome of canine SCCEDs treated with a combination of cotton-tip debridement (CTD), scalpel blade debridement (SBD), and superficial grid keratotomy (SGK). Medical records of dogs diagnosed with SCCED and treated by the same diplomate (FJO) from 2011 to 2019 were reviewed. Age, breed, sex, affected eye, time of onset before treatment, previous procedures performed, time to healing, need for a second treatment, and complications were reported. A total of 308 eyes (291 dogs) met the inclusion criteria and were included in the study. All dogs received the same treatment (CTD+SBD+SGK) and the same topical medication (tobramycin 0.3% solution and sodium chloride 5% ointment). All eyes healed. Mean age at presentation was 9years and 6months (114.4±SD 28.0months), and Boxer was the most common breed (93/308; 30.2%). Mean corneal healing time was 11.5days (±SD 6.6). Complications occurred in 15/308 (4.9%) eyes. The three main complications observed were infected epithelial ulcer, infected stromal ulcer, and melting corneal ulcer, and 7/15 (46.7%) of the complications were diagnosed in Boston Terrier. Healing occurred after one treatment in 299/308 (97.1%) eyes, and the remaining cases needed a second treatment. CTD+SBD+SGK is an inexpensive and efficient treatment for SCCED in dogs. Boston Terrier may be at higher risk of developing complications following this procedure.

The use of tear ferning test in cats for evaluation of ocular surface

BackgroundThe tear film is a trilaminar fluid composed mainly of lipids, electrolytes, proteins and water. It is responsible for lubrication, nutrition and protection against microbial and toxic agents. Disruption of any these components may weaken the ocular surface, making it more susceptible to disease. Increasing evidence suggests that qualitative tear film deficiencies are an important predisposing factor or cause of some of the most common and challenging ocular diseases in cats, including conjunctivitis, corneal ulcer, spontaneous chronic corneal epithelial defects (SCCED), pigmentary keratitis, corneal sequestrum and dry eye syndrome. The aim of this study was to describe the tear ferning test in healthy cats and to compare the results by using two grading scales for humans. Tear samples were collected using Schirmer tear test (STT) strips from 60 healthy cats, and, after centrifuging the strips to obtain the samples, the aliquot was placed on clean microscope glass until it dried and the tear ferning patterns were observed under a polarized light microscope and classified according to the Rolando and Masmali grading scales.ResultsFerning patterns in the lower grades showed full crystallization with high density, without gaps between the ferns and branches, forming several nuclei that were easily distinguished. According to the Rolando scale, 50% (60/120), 46.6% (56/120) and 3.4% (4/120) of eyes showed type I, II and III patterns, respectively. According to the Masmali scale, 15% (18/120), 56.6% (68/120 eyes) and 28.4% (34/120) of eyes showed grade 0, 1 and 2 patterns, respectively. No difference was observed between the right and left eyes for both Rolando (P = 0.225) and Masmali (P = 0.683) scales.ConclusionsThe tear ferning test is a qualitative test that can be used in cats as a complementary evaluation of the ocular surface. While the Rolando scale showed an increased prevalence of types I and II, the Masmali scale showed an increased prevalence of grades 1 and 2. This can be attributed to the species-specific differences between human and feline tear film. So Masmali grade 2 can be considered a normal tear pattern for the species, because all the cats used in study were clinically healthy. For this reason, future complementary studies are necessary for comparing healthy eyes and eyes with different ocular surface disease in cats. Both scales can be feasible options for grading tear crystallization in cats, but as Rolando scale included 96.6% of the samples in the 2 types that are considered normal for humans, we think that this scale seemed to be more precise to classify crystallization pattern in cats. The crystallization patterns observed in this study can form the basis for standardizing ocular surface parameters in cats.

Clinical characteristics and treatment of spontaneous chronic corneal epithelial defects (SCCEDs) with diamond burr debridement.

To document the characteristics of unilateral, bilateral SCCEDs, and unilateral SCCED with a subsequent SCCED in the contralateral eye that are treated with diamond burr debridement (DBD). Medical records of canine SCCEDs who have received DBD between 2010 and 2018 were retrospectively reviewed. Signalment, eye(s) affected, procedures performed, time to detected healing, and complications were statistically analyzed. Two hundred and forty-nine dogs had unilateral SCCEDs (85.0%), 13 dogs (4.4%) had bilateral SCCEDs, and 31 dogs (10.6%) had unilateral SCCED with a subsequent SCCED in the contralateral eye, 26 of which occurred within 24months following the unilateral SCCED. No significant differences in healing rates after one DBD were found between different presentations of SCCEDs. Boxers are 2.3 times more likely to have subsequent SCCED in their contralateral eye than non-Boxer breeds. Of the 341 SCCEDs (293 dogs) in the total study population, 252 eyes (73.9%) achieved healing after undergoing one DBD. Fifteen cases were lost to subsequent follow-up, and 58 eyes (17.0%) required additional intervention after a DBD. Complications occurred in 16 eyes (4.7%) including 13 cases of keratomalacia and three cases of anterior uveitis. Diamond burr debridement is a safe and effective treatment for different presentations of SCCEDs. No significant differences in healing rates after one DBD were found between different presentations of SCCEDs. Particularly in Boxers, a new SCCED may develop in the contralateral eye, typically within 24months following a presentation of unilateral SCCED.

Clinical trial of adjunctive autologous platelet-rich plasma treatment following diamond-burr debridement for spontaneous chronic corneal epithelial defects in dogs.

OBJECTIVE To evaluate the effects of adjunctive treatment with autologous platelet-rich plasma (PRP) on corneal reepithelialization, vascularization, and fibrosis in dogs with spontaneous chronic corneal epithelial defects (SCCEDs). DESIGN Randomized, controlled, double-masked clinical trial. ANIMALS 40 client-owned dogs with uncomplicated SCCEDs. PROCEDURES All dogs were treated with diamond-burr epithelial debridement (DBD) of affected eyes, topical tobramycin solution and atropine sulfate ointment application, and Elizabethan collar placement for 4 weeks. Dogs were randomly assigned to topical ocular administration of autologous PRP (n = 20) or artificial tear solution (control group; 20) 4 times daily for 28 days. Recheck examinations were performed approximately 2 and 4 weeks after treatment began to evaluate SCCEDs for corneal reepithelialization, and semiquantitative corneal vascularization and corneal fibrosis scores were assigned according to affected corneal surface area. Results were compared between groups. RESULTS All dogs completed the study. The SCCEDs had completely reepithelialized in 11 (55%) control dogs and 12 (60%) PRP-treated dogs by the 2-week reevaluation, and in 15 (75%) control dogs and 18 (90%) PRP-treated dogs by the 4-week reevaluation. No significant differences were identified between groups in these proportions nor in mean differences from pretreatment scores for corneal vascularization and fibrosis. CONCLUSIONS AND CLINICAL RELEVANCE In this preliminary study involving dogs with uncomplicated SCCEDs, topical PRP administered as an adjunctive treatment following DBD had no significant effect on healing. A larger study is warranted to support or refute these findings and to determine the effects of adjunctive PRP treatment for dogs with complicated SCCEDs.

Canine superficial chronic corneal epithelial deficits (SCCEDs)

Spontaneous chronic corneal epithelial defects or ‘SCCED’ lesions are superficial corneal ulcers that occur most commonly in middle-aged, usually large breed dogs, although they may be seen in any breed. They are moderately common in general practice and can be frustrating to treat. This article outlines the aetiopathogenesis, clinical diagnosis and possible treatment options.

Lack of effect of a topical regenerative agent on re-epithelialization rate of canine spontaneous chronic corneal epithelial defects: A randomized, double-masked, placebo-controlled study

Spontaneous chronic corneal epithelial defects (SCCEDs) are characteristic ulcers in dogs that are refractory to healing. The aim of the study was to evaluate the use of a topical regenerative agent to promote healing of SCCEDs. Nineteen dogs (20 eyes) were randomized to receive either regenerative agent (10 eyes) or placebo (10 eyes) every 48h following corneal debridement, which was repeated 1 week later if the SCCED had not yet healed. The mean±standard deviation time to re-epithelialization was 17.3±12.8 days for the group treated with a topical regenerative agent and 19.3±11.7 days for the group treated with a placebo; the cumulative healing rates were not statistically different (P>0.650). A positive association was found between the initial size of the ulcer and the time to re-epithelialization (r=0.555, P=0.011). Although well tolerated by dogs, there was no therapeutic advantage in using a topical regenerative agent for re-epithelialization of SCCEDs.

Advanced regeneration for spontaneous chronic corneal epithelial defects (SCCED)

Advanced regeneration for spontaneous chronic corneal epithelial defects (SCCED)

Effect of bandage contact lens wear and postoperative medical therapies on corneal healing rate after diamond burr debridement in dogs.

To determine the effect of bandage contact lens wear and type of post-operative medical treatment on corneal healing rates in dogs after diamond burr debridement. 237 client-owned dogs. Canine patients having undergone diamond burr debridement (DBD) for treatment of spontaneous chronic corneal epithelial defects (SCCEDs) were included. Patients were put into 1 of 12 different groups based on type of postoperative medical regimen and whether a bandage contact lens (BCL) was utilized. Each dog was examined on a routine basis until the cornea was fluorescein negative. Data points collected included age, sex, breed, diabetic status, eye affected, Schirmer tear test 1, rebound tonometry, type and frequency of topical antibiotic, use of topical sodium chloride, use and retention of BCL, and days until healed. A total of 237 dogs, each contributing one eye to the study, underwent DBD for SCCEDs. All eyes treated had estimated median±standard error (SE) days to heal of 9.37±0.42days. When sodium chloride and BCL were utilized, ofloxacin had a significantly shorter median healing time when compared to oxytetracycline (adjusted P=0.0158) and tobramycin (adjusted P=0.0261). BCL use significantly improved healing times (P=0.0002). Overall BCL retention rate was 62.02% (80 of 129). PureVision lenses were retained more often compared to Acrivet lenses (P<0.0001). Overall, BCL retention significantly improved healing rates (P=<0.0001). Postdebridement antibiotic type or use of sodium chloride ointment had minor effects on healing rates. Bandage contact lens use and retention significantly improves healing times.

Immediate effects of diamond burr debridement in patients with spontaneous chronic corneal epithelial defects, light and electron microscopic evaluation.

To evaluate immediate effects of diamond burr debridement (DBD) on the cornea of canine patients diagnosed with spontaneous chronic corneal epithelial defects (SCCEDs). Eight client owned dogs with SCCEDs. Nine eyes from eight dogs with SCCEDs underwent superficial keratectomy (SK). The ulcerated area was divided into quadrants with a 300-micron restricted depth knife. Two of four quadrants underwent DBD for 40-60s. A SK followed immediately. One burred section and one nonburred section were fixed with formaldehyde 10% and underwent light microscopy (LM). The remaining quadrants from five eyes were fixed with glutaraldehyde 2.5% and underwent transmission electron microscopy (TEM). Masked pathologists evaluated the samples. A student's paired t-test was used to analyze the data. With LM all nonburred samples had a superficial stromal hyaline acellular zone (HAZ), seven of the burred samples had an intermittent HAZ and in two burred samples this zone was absent. The HAZ thickness of burred samples (1.062±0.664μm) was significantly thinner than that of the nonburred samples (4.309±1.348μm) (P<0.0001). Transmission electron microscopy showed an absence of basement membrane and the presence of an amorphous, fine fibrillar material in the superficial stroma in nonburred samples. This material was intermittent or absent in burred samples. DBD significantly reduces the superficial stromal HAZ in SCCEDs. A reduction of its thickness may be responsible for the healing rates reported with DBD.

Heat-shock protein expression in canine corneal wound healing.

Heat-shock proteins, particularly the 70-kDa member (Hsp70), have been implicated in facilitating wound healing in multiple tissues. Expression and localization of three HSPs were assessed in normal and wounded canine corneas to elucidate a role in epithelial healing. Paraffin-embedded normal corneas, acute and repeatedly abraded corneas, and keratectomies of spontaneous chronic corneal epithelial defects (SCCEDs) were subjected to routine immunohistochemistry for Hsp27, 47, and 70 expression. Ex vivo corneal defects were created and treated with anti-HSPs or IgG controls, and wound healing was monitored. Primary cultures of canine corneal stromal fibroblasts and corneal epithelial cells were treated with exogenous Hsp70, and an artificial wound was created invitro to monitor restoration of the monolayer. Normal canine corneas exhibited constitutive expression of all HSPs evaluated. Inducible expression was demonstrated in acutely wounded tissues, and expression in the chronically abraded corneas was relocalized. All HSP expression was below the limits of detection in the epithelium of SCCED samples. Inhibition of HSPs in culture resulted in delayed wound healing when compared to controls. Hsp70-treated fibroblasts demonstrated significantly (P<0.001) increased migration and proliferation compared to the vehicle control; however, there was no significant effect of exogenous Hsp70 on corneal epithelial cells. These findings suggest that HSPs are induced in the normal canine cornea during re-epithelialization. Hsp70 expression is likely important for inducing the cytoarchitectural remodeling, migration, and proliferation necessary early in the canine corneal healing response, and suppressed expression may contribute to the pathophysiology of nonhealing defects.

Use of bandage contact lenses for treatment of spontaneous chronic corneal epithelial defects in dogs.

To determine whether polyxylon bandage contact lenses influence healing time and ocular comfort in the management of spontaneous chronic corneal epithelial defects in dogs. Twenty dogs with spontaneous chronic corneal epithelial defects were included. All dogs were treated by debridement under topical anaesthesia at the first presentation. Ten dogs were assigned to the study group (application of a polyxylon bandage contact lens), and the remaining ten served as a control group. The healing time and ocular (dis)comfort were evaluated by assessment of the clinical findings and an owner-based questionnaire. All dogs received the same topical and systemic medication. Healing time for dogs in the study population was significantly shorter (mean 14±0 days) than for dogs in the control group (mean 36±17 days; P=0·005). The spontaneous chronic corneal epithelial defects had completely healed at the first recheck in all dogs with a polyxylon bandage contact lens. The duration of blepharospasm following debridement was significantly shorter in the study population (mean 4±4 days) than in the control group (mean 30±20 days; P=0·001). The use of polyxylon bandage contact lenses is beneficial in the management of spontaneous chronic corneal epithelial defects.

Effect of corneal contact lens wear on healing time and comfort post LGK for treatment of SCCEDs in boxers.

To determine whether dogs with spontaneous chronic corneal epithelial defects (SCCEDs) would heal faster and with an improved comfort score following linear grid keratotomy (LGK) combined with corneal contact lens (Acrivet(™) ) wear when compared to dogs having the LGK procedure alone. Prospective study. Twenty-seven boxer dogs (27 eyes) diagnosed with a SCCEDs were enrolled in the study. A LGK was performed on all dogs under dexmedetomidine and butorphanol sedation. Fourteen eyes were randomly assigned to receive a corneal contact lens. The dogs were evaluated typically at 7, 10, and 14 days or until the ulceration was healed. Client surveys were completed by the owners to subjectively assess comfort level and contact lens retention. Statistical analyses were performed utilizing generalized linear models and survival analysis with the Wilcoxon-Gehan test to evaluate group differences. All ulcers healed after the LGK procedure. Dogs with bandage contact lenses had a statistically significant (P = 0.035) decrease in median healing time (7 days (95% CI [7,9]) compared to those without contact lenses (10 days (95% CI [7,12])). There was no difference in subjective comfort score between treatment groups. Early contact loss occurred in 28.6% (95% CI [8.4%, 58.1%]) of dogs. All of the Acrivet(™) ruler corneal measurements agreed to within 1 mm (95% CI [87.2%, 100%]) of the Jameson caliper measurements of horizontal corneal diameter. The use of corneal bandage contact lenses significantly decreased median healing time although there was no effect on subjective comfort score. The Acrivet(™) ruler measurements were accurate in determining corneal diameter and therefore contact lens size.

Histopathological features of equine superficial, nonhealing, corneal ulcers.

To evaluate corneal changes associated with chronic, nonhealing, superficial, corneal ulcers in horses via common histopathological stains. Retrospective study. Twenty-four horses diagnosed with chronic, nonhealing, superficial, corneal ulceration. The medical records of horses evaluated at North Carolina State University's Veterinary Teaching Hospital (NCSU-VTH) from 2005 to 2011, diagnosed with a chronic, nonhealing, superficial, corneal ulcer and treated with superficial keratectomy (SK) were reviewed. Inclusion criteria were superficial corneal ulceration, no cellular infiltration via slit-lamp biomicroscopy, no microorganisms evident on corneal cytology, and acquisition of samples for aerobic bacterial and common fungal cultures. Corneal tissue samples were evaluated histopathologically for the presence or absence of a nonadherent epithelial 'lip', epithelial dysmaturity, intraepithelial inflammatory cells, an acellular hyaline zone in the anterior stroma, and stromal inflammatory cells, fibrosis and vascularization. In the majority of analyzed samples, epithelial cells adjacent to the ulcerated site showed nonadherence to the basement membrane and dysmaturity. Intraepithelial inflammatory cell infiltration was uncommon. Histopathological features of an anterior stromal hyaline zone, intrastromal inflammation, fibrosis and vascularization were variably present. The most consistent histopathological characteristics of equine chronic, nonhealing, superficial, corneal ulcers include epithelial nonadherence, epithelial dysmaturity and mild to moderate stromal inflammation; however, one set of histopathological characteristics does not definitively define this syndrome in horses. Additionally, the anterior stromal acellular hyaline zone commonly cited in canine spontaneous chronic corneal epithelial defects (SCCED) is not a consistent finding in equine corneas.

Management of spontaneous chronic corneal epithelial defects (SCCEDs) in dogs with diamond burr debridement and placement of a bandage contact lens

Objective To describe the outcome of canine spontaneous chronic corneal epithelial defects (SCCED) treated with diamond burr debridement (DBD) and bandage contact lens placement (BCL). Animal studied Forty eyes of 36 dogs presenting to a single private practice. Procedures A retrospective review of medical records was performed. Cases were eligible for inclusion if they were newly diagnosed with SCCED by a veterinary ophthalmologist and treated with DBD/BCL. All patients received a complete ocular examination followed by DBD using a battery-powered, handheld motorized burr (Algerbrush(®) , Alger Equipment Company, Lago Vista, TX, USA). A BCL was placed post-debridement in all patients. Data were analyzed for sex, age, breed, duration of clinical signs prior to DBD; number of debridements required before healing was achieved; contact lens retention, complications attributed to DBD, and additional surgical interventions were required to achieve healing. Results The median time to first recheck examination was 7 days (IQR 7-9 days) with 28/40 (70%) of cases healed at this examination. The mean time to second recheck examination was 15.5 ± 5.5 days with 37/40 (92.5%) healed by this examination. The median time to final recheck examination was 19 days (IQR 18-35.5 days) with a range of 18-52 days. All cases resolved by the third and final recheck examination. A second DBD/BCL was performed in 5/40 (12.5%) of cases. The BCL retention rate was 95% over all examination time points. No case required a keratectomy or other surgical intervention to achieve healing. The only complication observed was one case of suspected bacterial keratitis post-DBD/BCL. Conclusions Results suggest that DBD/BCL is safe and effective for treatment of canine SCCED.