Results and side effects of gentamicin treatment of chronic uveitis in Swedish horses
Chronic or recurrent uveitis is a relatively common and very serious autoimmune eye disease in horses that can lead to blindness. It is often treated with anti-inflammatory drugs, which in long-term treatment carries a high risk of side effects. Now a new treatment has been evaluated in Sweden.
In recent years, an alternative treatment involving the injection of the antibiotic gentamicin into the vitreous humor of the eye has been developed. Researchers at the Swedish University of Agricultural Sciences have now evaluated the treatment under Swedish conditions.
The treatment involves injecting a very low dose of gentamicin into the posterior part of the eye, the vitreous, on a standing horse that has been given sedative medication and local anesthesia, in order to reprogram or kill the immune system cells that drive inflammation in the eye.
Of the treated horses in the study, 41% showed reduced inflammation in the eye despite otherwise stopping or greatly reducing anti-inflammatory treatment. This result is significantly worse than what has been seen in previous studies conducted in other countries. One possible reason for the difference is that Swedish horses have a higher proportion of anterior uveitis than horses in other countries, and a significantly lower frequency of uveitis involving the bacterium Leptospira.
Gentamicin injections into the eye have potential side effects, with retinal damage and total cataracts being some of the most serious. In the study, an association between the injection and visual impairment was seen in more than 20% of eyes, which is a higher proportion than in previous studies. However, it is important to remember that even uveitis (inflammation) that is not treated or controlled can cause the same types of vision loss problems.
The study shows that low-dose gentamicin in the vitreous humor is a form of treatment that in some cases can give positive results with reduced inflammation in chronic or recurrent uveitis in horses, but that Swedish horses with mainly anterior uveitis have a generally poorer treatment outcome than seen in previous studies. The injection can also cause serious side effects resulting in impaired vision or blindness, and should only be performed after careful evaluation and with great consideration.
Link to the publication
https://doi.org/10.1111/evj.14056
Reference
, , . Equine uveitis: Outcome and adverse effects after one or two intravitreal low-dose gentamicin injections. Equine Vet J. 2024.
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