Equine keratomycosis in Switzerland: a retrospective evaluation of 35 horses (January 2000-August 2011).
Authors: Voelter-Ratson K, Pot S A, Florin M, Spiess B M
Journal: Equine veterinary journal
Summary
# Equine Keratomycosis in Switzerland: Clinical Outcomes and Treatment Approaches Keratomycosis represents a serious ocular threat to horses, yet limited European data exist on its prevalence, causative organisms and treatment efficacy compared with cases reported from other geographical regions. A Swiss referral centre reviewed 36 eyes from 35 horses diagnosed with keratomycosis between 2000 and 2011, analysing case presentation, surgical and medical interventions, treatment duration and visual outcomes. The majority of cases (86.1%) presented as ulcerative keratitis, and whilst 63.9% of eyes retained at least partial vision, 30.5% required enucleation and two horses were euthanised; notably, neither prior antimicrobial or corticosteroid therapy, patient age, nor sex significantly influenced survival outcomes. Perhaps surprisingly, no meaningful difference emerged between different antifungal protocols (including voriconazole-based regimens versus other combinations) or surgical approaches in terms of globe preservation, suggesting that individual case management and aggressive combined medical-surgical intervention may be more important than the specific agents chosen. Farriers and veterinarians should recognise keratomycosis as a vision-threatening emergency requiring prompt specialist referral and intensive treatment, whilst the findings underline an urgent need for European studies identifying fungal species involved and their in-vitro antifungal susceptibilities to guide more targeted therapeutic protocols.
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Practical Takeaways
- •Keratomycosis in horses carries a guarded prognosis with vision loss or globe loss in ~36% of cases; aggressive combined medical and surgical treatment may maximize globe survival but doesn't guarantee vision
- •Antifungal drug choice (voriconazole vs. alternatives) appears less critical than initiating treatment promptly, suggesting that availability and early intervention matter more than specific agent selection
- •Fungal identification from corneal samples is inconsistent (only 33% culture positive), so diagnosis often relies on clinical signs and cytology rather than culture confirmation
Key Findings
- •86.1% of 36 eyes with keratomycosis presented as ulcerative keratitis
- •63.9% of eyes achieved at least partial vision while 30.5% required enucleation
- •Only 2 of 6 fungal cultures identified Aspergillus spp., indicating difficulty in fungal pathogen identification
- •Different medical treatment protocols (voriconazole-based vs. other antifungal combinations) and surgical approaches did not significantly differ in outcome