Use of Intravitreal Injection of Gentamicin in 71 Horses With Equine Recurrent Uveitis.
Authors: Launois Thomas, González Hilarión Laura Margarita, Barbe Florent, Leurquin Céline, Bihin Benoît, Hontoir Fanny, Dugdale Alex, Vandeweerd Jean-Michel
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Equine recurrent uveitis (ERU) remains one of the most challenging conditions in equine ophthalmology, and intravitreal antibiotic therapy represents an emerging approach to achieve sustained control. Between 2010 and 2016, researchers retrospectively evaluated 71 horses receiving a single intravitreal injection of gentamicin (6 mg in 0.3 mL) as treatment for ERU, using standardised scoring of aqueous flare and vitreous haze at baseline and at multiple intervals up to two years post-injection. Of the 71 treated eyes, 42 (59%) achieved complete resolution of measurable intraocular inflammation, whilst a further 21 of the remaining 29 horses demonstrated clinical improvement; notably, 70 of the 71 horses remained free from observable inflammatory episodes and did not require topical ocular medication during follow-up, with telephone confirmation obtained at least six months after treatment. Whilst adverse effects were documented—including ocular hypotension in 92% of eyes at baseline (80% at two years), increasing lens opacities (78% to 90%), and retinal folds (28% to 36%)—the therapeutic benefit of achieving prolonged quiescence without ongoing medication represents significant value for horses with chronic ERU. Although the retrospective design and variable follow-up intervals warrant cautious interpretation, low-dose intravitreal gentamicin warrants consideration as part of the therapeutic arsenal for cases refractory to conventional management, particularly where reducing medication burden and preventing recurrent flare-ups are priorities.
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Practical Takeaways
- •Low-dose intravitreal gentamicin injection (6 mg in 0.3 mL) shows promise for controlling recurrent uveitis and maintaining long-term ocular quiescence in horses
- •Most treated horses (99%) remained free from observable inflammation episodes at 6+ months follow-up, potentially reducing need for ongoing ocular medication
- •Be aware that this treatment carries risks including ocular hypotension, progressive lens opacities, and retinal folds that warrant careful monitoring and informed owner consent
Key Findings
- •42 of 71 horses (59%) achieved zero inflammation scores at final examination
- •21 of 25 horses with follow-up re-examinations showed improved inflammation scores
- •70 of 71 horses (99%) did not develop new observable inflammation episodes or require ocular medication at 6+ months post-injection
- •Ocular hypotension persisted in 80% and lens opacities increased to 90% of horses re-evaluated at 2 years