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Difetti palatini congeniti nel cane e nel gatto : 1. parte : Approccio clinico, diagnostico e terapeutico
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AMNIOTIC MEMBRANE TRANSPLANTATION FOR OCULAR SURFACE RECONSTRUCTION IN VETERINARY MEDICINE
Full text linkThe fetal membrane is composed by the chorion, allantois and amnion. The AM is the inner layer. It consists of a single layer of ectodermally derived cuboidal to columnar cells, which form the epithelium, a basement membrane that connects with the chorion by a layer of mesenchyme which contains large amounts of collagen (stroma). Amniotic basement membrane and stroma contain cytokines, proteoglycans, collagen type I, III, IV, V and VII, laminin and fibronectin.
Different interesting properties of the AM have been described. Amniotic basement membrane, by serving as a “transplanted basement membrane”, acts as a new healthy substrate that facilitates migration of epithelial cells, reinforces adhesion of basal epithelial cells, promotes epithelial differentiation, and prevents epithelial apoptosis. Additionally AM produces various growth factors, inhibits protease activity, has anti-inflammatory, anti-angiogenic and antifibrotic effects. The non-immunogenicity of the AM was believed to be another important property. AM transplantation (AMT) has been widely described in human ophthalmology for the reconstruction of corneal and/or conjunctival surface in different diseases, such as: ocular surface neoplasia, pterygium, chemical and thermal burns, cicatrizing conjunctivitis, symblepharon release, bleb leakage, filtering surgery, persistent epithelial defects, non healing stromal ulcers, deep stromal ulcers and descemetoceles, neurotrophic keratopathy, limbal stem cells deficiency, bullous keratopathy, infectious keratitis, Stevens Johnson syndrome, melting ulcers, scleral melt and band keratopathy. In veterinary ophthalmology AMT has been described for the treatment of ocular surface neoplasia, bullous keratopaty, melting ulcers, symblepharon, immun-mediated keratitis and in conjunction with penetrating keratoplasty. The objective of our study was to evaluate the effects of amniotic membrane transplantation for reconstruction of the ocular surface in different diseases in dogs, cats and horses. We evaluated the cosmesis and visual function. In our case series we performed AMT with the inlay technique in 3 dogs (3 eyes), 6 cats (7 eyes) and 11 horses (11 eyes). The diseases treated were: 7 feline corneal sequestra, 4 corneal melting (1 dog and 3 horses), 2 dermoids (2 dogs), 4 keratomycosis (4 horses), 2 corneo-conjunctival squamous cell carcinoma (2 horses), 1 immunomediate keratitis (1 horse) and 1 corneal edema (1 horse). In our results the objective was obtained: we had successful outcome in 17 of the 21 eyes treated; no ocular pain was detected in the immediately postoperative period, the AM epithelialized quickly and, after the fibrovascular invasion of the AM, all the corneas obtained a good transparency and no recurrence was detected in our follow-up periods
Amniotic membrane transplantation for the treatment of feline corneal sequestrum : pilot study
No full textObjectives To describe and evaluate the use of equine amniotic membrane transplantation
after lamellar keratectomy for the treatment of corneal sequestrum in cats.
Methods Six cats (seven eyes) of various breed and ages with corneal sequestra were
treated surgically with lamellar keratectomy and amniotic membrane transplantation.
All the sequestra and a small piece of the amniotic membranes used for each surgery
were submitted for histopathologic examination.
Results Five of the seven eyes showed minimal level of scarring in the cornea and
good transparency. No recurrences of the sequestra have been noted during the
follow-up period (3–9 months). One eye had necrosis of the amniotic membrane
2 weeks after the surgery. The sequestrum of this eye showed a high level of bacterial
contamination on histopathology. Three months later the same cat developed a
descemetocele in the area where the necrotic amniotic membrane was rejected. A
second eye developed a perforation under the amniotic membrane two weeks after the
surgery. The sequestrum of this eye was deep and without vascularization.
Conclusion Amniotic membrane transplantation after lamellar keratectomy was a valid
procedure for surgical treatment of corneal sequestrum in cats. The procedure resulted
in excellent cosmesis and functional vision in five of seven eyes; although case selection
is important, particularly to exclude the very deep and non-vascularized sequestra
Use of episcleral cyclosporine implants in dogs with keratoconjunctivitis sicca: pilot study
No full textPurposeTo describe the use, tolerability, and efficacy of episcleral silicone matrix cyclosporine (ESMC) implants in dogs with keratoconjunctivitis sicca (KCS).
MethodsRetrospective study. ESMC implants (1.9cm length, 30% wt/wt CsA in silicone; with approximately 12mg of CsA loaded into them) were used in dogs with KCS responsive to topical CsA (good candidate, GC) or not responsive (poor candidate, PC). Ocular surface inflammation scores, Schirmer tear test (STT) values, and ocular discharge quantity were evaluated and compared.
ResultsTwenty-seven eyes (15 dogs) received an ESMC implant for KCS; 15 eyes were considered GC, and 12 were considered PC. Both GC eyes and PC eyes showed a significant increase in STT values (increase of 7.7 and 8.5mm/min; P=0.023 and P=0.003, respectively) after placement of ESMC implants (mean follow-up 182 and 10.4 +/- 15months, respectively). Clinical signs improved significantly in both groups during the same follow-up, with reduction in conjunctival hyperemia (P<0.001), corneal neovascularization (P=0.004), corneal opacity (P=0.003), and ocular discharge (P=0.002). ESMC implants were well tolerated by all dogs, but two eyes lost the device at 12-months and 1-week follow-up, respectively.
ConclusionsResults from this study suggest that the EMSC implants were well tolerated and efficacious in dogs with KCS responsive to topical CsA as well as dogs with poor response to topical therapy. Further study is needed to determine the duration of efficacy and optimal dose of CsA
Innesto di membrana amniotica per la ricostruzione della superficie oculare in 9 cavalli (marzo 2009-maggio 2010)= Amniotic membrane transplantation for ocular surface reconstruction in 9 horses (march 2009-may 2010)
No full textInnesto di membrana amniotica per la ricostruzione della superficie oculare in 11 cavalli
No full textPharmacological cytoreduction and sliding skin graft (h-plasty) for bilateral lower-eyelid squamous cell carcinoma in a pony
No full textPurpose. To describe the surgical approach to a bilateral lower eyelid squamous cell carcinoma (SCC) in a pony. Methods. A 9 year old mare, Connemara Pony, light hair, presented for a bilateral lower-eyelid infiltrating mass. No diagnostic test was performed and a bilateral SCC was suspected. The neoplasia invaded 50% of the length of the lower-eyelid in both eyes, including the medial cantus in the left one. Because of new promising approaches to SCC (Hyperthermia, Brachytherapy, Photodynamic therapy) as well as most immunotherapy and chemotherapy molecules were not available, palpebral surgery was considered. Due to the size of the lesions, a pre-surgical cytoreduction was performed by using Piroxicam 0,3mg/kg/24 hours PO associated to local application of Imiquimod cream 3 times a week for 3 weeks. Slight reduction of the lateral portion of the mass was noted in both eyes, and surgical approach with H sliding skin graft was performed under general anesthesia. Lower lacrimal punctum in left eye was sacrificed, but the canaliculus was cannulated for one month. Tobramycin ointment was given topically after surgery q 6 h OU until healing occurred and systemic antibiotics and non-steroidal antiinflammatory (Flunixin M.) were administered for 7 days. cells. Results. Hystopathology confirmed the diagnosis of bilateral SCC infiltrating lower eyelid and the surgical margins appeared free from neoplastic cells. A normal palpebral function was maintained bilaterally; no recurrence was noticed 2 years after surgery. Conclusions. Whenever a new approach to palpebral SCC is not available, cytoreduction associated to surgery can be considere
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