Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses
Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses
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DOI：
10.1111/evj.13399
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发表时间：
2021-01-19
影响因子：
2.2
通讯作者：
Liang, Siqi
中科院分区：
文献类型：
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作者：
Lyons, Victoria N.;Townsend, Wendy M.;Liang, Siqi
背景资料：羊膜提取物可提高几个物种角膜溃疡后上皮形成的速率，但尚未在马角膜中进行研究。目的：与单独使用抗生素、抗真菌和散瞳药物治疗的溃疡相比，评估羊膜提取物对马角膜溃疡上皮再形成的影响，并评估实验诱导的浅表溃疡后马角膜的愈合情况。方法：在每匹马的双侧角膜表面造成8 mm的溃疡。一只眼用羊膜提取物处理，另一只眼为对照。双眼均接受药物治疗。治疗眼接受羊膜提取物，对照眼接受羊膜提取物载体。用荧光素对溃疡进行染色，并以12小时为增量拍照，直到完全愈合。通过用ImageJ分析照片来确定溃疡表面积。使用混合线性模型比较治疗组之间的溃疡表面积和愈合时间。结果：无论采用何种治疗，愈合均分为两个阶段：初始快速阶段为0.88 mm（2）/hr，（95% CI：0.81-0.94 mm（2）/hr）持续约48-54小时，然后是0.07 mm（2）/hr（95% CI：0.04-0.09 mm（2）/hr）的第二个缓慢阶段。大多数眼睛在135.5 +/- 48.5小时内愈合。治疗（羊膜提取物vs.对照）与随时间推移的溃疡大小无显著相关性（P = 0.984）。不适是最小的，没有在所有horses.Main局限性：实验研究取得的结果可能与临床setting.Conclusions的结果不同：有没有显着差异，除了羊膜提取物的药物治疗马浅表角膜溃疡愈合率。观察到双相角膜愈合过程，初始快速阶段随后是缓慢阶段。羊膜提取物是否对感染或软化的马角膜溃疡有帮助还需要进一步的研究。
Background: Amniotic membrane extract enhances the rate of epithelialisation after corneal ulceration in several species but has not been studied in the equine cornea.Objectives: To evaluate the effect of amniotic membrane extract on re-epithelialisation of equine corneal ulcers compared with ulcers treated with antibiotic, antifungal and mydriatic medical therapy alone, and to evaluate equine corneal healing after experimentally induced superficial ulceration.Study design: Masked, randomised, controlled experimental trial.Methods: Superficial, 8 mm corneal ulcers were created bilaterally in each horse. One eye was treated with amniotic membrane extract and the opposite was control. Both eyes were treated with medical therapy. Treatment eyes received amniotic membrane extract, and control eyes received the amniotic membrane extract vehicle. Ulcers were stained with fluorescein and photographed in 12-hour increments until completely healed. Ulcer surface area was determined by analysing photographs with ImageJ. A mixed linear model was used to compare ulcer surface area and hours until healing between treatment groups. A regression model was also used to calculate corneal re-epithelialisation rate over time.Results: Regardless of therapy, healing occurred in two phases: an initial rapid phase of 0.88 mm(2)/hr (95% CI: 0.81-0.94 mm(2)/hr) for approximately 48-54 hours followed by a second, slow phase of 0.07 mm(2)/hr (95% CI: 0.04-0.09 mm(2)/hr). Most eyes healed within 135.5 +/- 48.5 hours. Treatment (amniotic membrane extract vs. control) was not significantly associated with size of ulcers over time (P = .984). Discomfort was minimal to absent in all horses.Main limitations: Results achieved experimental studies may differ from outcomes in the clinical setting.Conclusions: There was no significant difference in healing rate with addition of amniotic membrane extract to medical therapy for equine superficial corneal ulcers. A biphasic corneal healing process was observed, with an initial rapid phase followed by a slow phase. Further study will be needed to determine whether amniotic membrane extract will be helpful for infected or malacic equine corneal ulcers.