@article{pinto_mcmullen_linder_cullen_gilger_2015, title={Clinical, histopathological and immunohistochemical characterization of a novel equine ocular disorder: heterochromic iridocyclitis with secondary keratitis in adult horses}, volume={18}, ISSN={["1463-5224"]}, DOI={10.1111/vop.12234}, abstractNote={AbstractObjectiveTo describe the clinical, histopathologic and immunohistochemical characteristics of an equine ocular inflammatory disease resulting in anterior uveitis and corneal endothelial inflammation associated with iris pigment dispersion and retrocorneal fibrous membrane (RFM) formation.DesignRetrospective study.Animals studiedSixteen horses with evidence of pigmented keratic precipitates (KPs), corneal edema, and/or iris depigmentation. Information collected from the medical records included signalment, clinical signs, prereferral treatment duration and response to therapy, ophthalmic examination findings, postreferral treatment, response to therapy, and outcome.ResultsTwenty‐one eyes from 16 horses were affected. Age ranged between 9 and 25 years (Average 16.1 years). Blepharospasm, epiphora, and/or corneal opacification were the first clinical signs noted. At the time of referral pigmented KPs, corneal edema, iridal depigmentation, and retrocorneal membranes were commonly seen. Treatment included topical and/or systemic anti‐inflammatories and antibiotics with variable response. Reduction or cessation of anti‐inflammatory therapy resulted in worsening of clinical signs and disease progression. Eight eyes ultimately required enucleation. Histopathology changes include iridal pigment loss and dispersion, RFM formation, and keratitis. Variable degrees of lymphoplasmacytic inflammation were dominated by T‐cells within the corneal stroma, RFM, iris, and ciliary body with occasional multinucleated giant cells.ConclusionsHeterochromic iridocyclitis with secondary keratitis (HIK) is characterized by uveal inflammation with pigment dispersion and suspected corneal endothelial dysfunction. Horses being treated for HIK require diligent and frequent follow‐up examinations in combination with aggressive local immune suppression to control the disease. However, HIK may not respond to therapy and enucleation may ultimately be required to ensure the horse's comfort.}, number={6}, journal={VETERINARY OPHTHALMOLOGY}, author={Pinto, Nelson I. and McMullen, Richard J., Jr. and Linder, Keith E. and Cullen, John M. and Gilger, Brian C.}, year={2015}, month={Nov}, pages={443–456} }
 @article{mcmullen_gilger_michau_2014, title={Modified lamellar keratoplasties for the treatment of deep stromal abscesses in horses}, volume={18}, ISSN={1463-5216}, url={http://dx.doi.org/10.1111/vop.12227}, DOI={10.1111/vop.12227}, abstractNote={AbstractObjectiveTo describe a surgical modification of deep lamellar endothelial keratoplasty (DLEK) and posterior lamellar keratoplasty (PLK) procedures, to facilitate surgery on standing horses under‐sedation.Animals studiedFour client‐owned horses, for which the owners declined surgery under general anesthesia, underwent standing corneal lamellar keratoplasty procedures for the treatment of deep corneal stromal abscesses.ProceduresAll four horses were placed in stocks and sedated with detomidine. Local eyelid and retrobulbar blocks were performed to provide local analgesia and akinesia, and each horse's head was stabilized and supported by soft pads placed on a mobile cart. Deep lamellar endothelial keratoplasties (DLEKs) and posterior lamellar keratoplasties (PLKs) were performed on two horses each, for the treatment of deep stromal abscesses (DSA). Following the first DLEK, a mid‐stromal two‐step anterior lamellar keratectomy modification was used to facilitate rapid closure of the anterior chamber immediately following removal of the abscess.ResultsEach of the four horses had similar cosmetic and postoperative visual outcomes, compared to previously published results. Intra‐operative complications were most prevalent in the first DLEK case (i.e., focal iris and lens damage and postoperative anterior chamber collapse) and were all but eliminated in the remaining three cases. Similar to previously reported findings, greater postoperative corneal fibrosis was observed in the DLEK cases.ConclusionsIn horses with deep stromal or endothelial abscesses, for which general anesthesia is not an option, both the modified DLEK and PLK corneal procedures may be performed as an alternative to enucleation on the standing, sedated horse.}, number={5}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={McMullen, Richard J., Jr. and Gilger, Brian C. and Michau, Tammy M.}, year={2014}, month={Oct}, pages={393–403} }
 @article{edelmann_mcmullen_stoppini_clode_gilger_2014, title={Retrospective analysis of equine cataract surgery – visual outcomes vs age, IOL, and ERU status (35 cases)}, volume={17}, ISSN={["1463-5224"]}, DOI={10.1111/vop.12185}, abstractNote={AbstractObjectiveTo determine the effect of age at the time of surgery, intraocular lens (IOL) placement, and presence of chronic uveitis on visual outcome after phacoemulsification and aspiration (PA) of cataracts in horses.Animals studiedRecords of 41 horses (46 eyes) receiving unilateral or bilateral PA.MethodsRetrospective analysis of horses receiving unilateral or bilateral PA at the NCSU‐VTH (35 horses, 39 eyes) and in Northern Italy (six horses, seven eyes) was performed. Visual status at last follow‐up was compared to age at the time of surgery, IOL status, and presence of chronic uveitis preoperatively. Seven horses with chronic uveitis also underwent placement of a suprachoroidal cyclosporine implant. Clinical ophthalmic examinations and owner questionnaires were used to evaluate visual status.ResultsTwenty‐one of 46 eyes (46%) received an IOL and 12 of 46 eyes (26%) had chronic uveitis. Overall, 25 of 46 eyes (54%) were visual at last follow‐up (mean 35.1 ± 34.8 months). Age (mean 8.6 ± 7.7 years) was not significantly associated with visual outcome. Fourteen of 21 (67%) pseudophakic eyes and 11 of 25 (44%) aphakic eyes were visual at last follow‐up (P = 0.342). Eyes with preoperative chronic uveitis were significantly less likely to be visual (3 of 12 eyes [25%]) than horses without preoperative chronic uveitis (22 of 34 eyes [65%]) (P = 0.023).ConclusionsHorses with chronic uveitis had significantly less favorable visual outcome after PA. Older age at surgery and IOL use were not associated with poor visual outcome.}, journal={Veterinary Ophthalmology}, author={Edelmann, Michele L. and McMullen, Richard, Jr. and Stoppini, Riccardo and Clode, Alison and Gilger, Brian C.}, year={2014}, pages={160–167} }
 @article{gilger_histed_pate_clode_mcmullen_2010, title={CASE REPORT: Anomalous nasolacrimal openings in a 2-year-old Morgan filly}, volume={13}, ISSN={1463-5216}, url={http://dx.doi.org/10.1111/j.1463-5224.2010.00823.x}, DOI={10.1111/j.1463-5224.2010.00823.x}, abstractNote={This case report describes the clinical, diagnostic, computed tomography findings, and surgical treatment of a 2-year-old Morgan filly with bilateral, proximal, and distal anomalous nasolacrimal duct openings.}, number={5}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={Gilger, Brian C. and Histed, James and Pate, Diana O. and Clode, Alison B. and McMullen, Richard J.}, year={2010}, month={Sep}, pages={339–342} }
 @article{mcmullen_davidson_campbell_salmon_gilger_2010, title={Evaluation of 30- and 25-diopter intraocular lens implants in equine eyes after surgical extraction of the lens}, volume={71}, ISSN={0002-9645}, url={http://dx.doi.org/10.2460/ajvr.71.7.809}, DOI={10.2460/ajvr.71.7.809}, abstractNote={Abstract
Objective—To determine appropriate intraocular lens (IOL) implant strength to approximate emmetropia in horses.
Sample Population—16 enucleated globes and 4 adult horses.
Procedures—Lens diameter of 10 enucleated globes was measured. Results were used to determine the appropriate-sized IOL implant for insertion in 6 enucleated globes and 4 eyes of adult horses. Streak retinoscopy and ocular ultrasonography were performed before and after insertion of 30-diopter (D) IOL implants (enucleated globes) and insertion of 25-D IOL implants (adult horses).
Results—In enucleated globes, mean ± SD lens diameter was 20.14 ± 0.75 mm. Preoperative and postoperative refractive state of enucleated globes with 30-D IOL implants was −0.46 ± 1.03 D and −2.47 ± 1.03 D, respectively; preoperative and postoperative difference in refraction was 2.96 ± 0.84 D. Preoperative anterior chamber (AC) depth, crystalline lens thickness (CLT), and axial globe length (AxL) were 712 ± 0.82 mm, 11.32 ± 0.81 mm, and 40.52 ± 1.26 mm, respectively; postoperative AC depth was 10.76 ± 1.16 mm. Mean ratio of preoperative to postoperative AC depth was 0.68. In eyes receiving 25-D IOL implants, preoperative and postoperative mean refractive error was 0.08 ± 0.68 D and −3.94 ± 1.88 D, respectively. Preoperative AC depth, CLT, and AxL were 6.36 ± 0.22 mm, 10.92 ± 1.92 mm, and 38.64 ± 2.59 mm, respectively. Postoperative AC depth was 8.99 ± 1.68 mm. Mean ratio of preoperative to postoperative AC depth was 0.73.
Conclusions and Clinical Relevance—Insertion of 30-D (enucleated globes) and 25-D IOL implants (adult horses) resulted in overcorrection of refractive error.}, number={7}, journal={American Journal of Veterinary Research}, publisher={American Veterinary Medical Association (AVMA)}, author={McMullen, Richard J. and Davidson, Michael G. and Campbell, Nigel B. and Salmon, Jacklyn H. and Gilger, Brian C.}, year={2010}, month={Jul}, pages={809–816} }
 @article{gilger_wilkie_clode_mcmullen_utter_komaromy_brooks_salmon_2010, title={Long-term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis}, volume={13}, ISSN={1463-5216}, url={http://dx.doi.org/10.1111/j.1463-5224.2010.00807.x}, DOI={10.1111/j.1463-5224.2010.00807.x}, abstractNote={OBJECTIVE
To determine the long-term efficacy, complications, and duration of effect of a cyclosporine (CsA) suprachoroidal implant (CSI) in horses with equine recurrent uveitis (ERU).


METHODS
Horses with ERU were treated with a 6-mm diameter, 25 mg, reservoir matrix CsA implant in the deep sclera adjacent to the suprachoroidal space. Horses with follow-up >1 year were examined for frequency of uveitis episodes, complications, and vision at last recheck.


RESULTS
Data from 151 eyes of 133 horses from the USA and Europe that had CsA devices implanted for ERU were reviewed. Follow-up time ranged from 13 to 85 months after surgery, with a mean and median follow-up time of 28.9 and 26.3 months, respectively. Overall, at last follow-up 78.8% of eyes were considered visual and the overall mean frequency of uveitis episodes after CSI was 0.09 ± SD 0.08 episodes per month. The most common complications leading to vision loss at last follow-up were persistent uveitis episodes (54%), glaucoma (22%), mature cataracts (16%), and retinal detachment (6%). Persistent uveitis episodes tended to be the highest cause of vision loss in horses with <24 months and >48 months of follow-up.


CONCLUSIONS
This study demonstrated the long-term maintenance of vision of horses with ERU implanted with a CSI. The increased vision loss related to uveitis episode of inflammation in eyes after the likely depletion of CsA from the CSI suggests that a repeat CSI may be required at or before 48 months after surgery.}, number={5}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={Gilger, Brian C. and Wilkie, David A. and Clode, Allison B. and McMullen, Richard J., Jr. and Utter, Mary E. and Komaromy, Andras M. and Brooks, Dennis E. and Salmon, Jacklin H.}, year={2010}, month={Sep}, pages={294–300} }
 @article{mcmullen jr._clode_gilger_2009, title={Infrared digital imaging of the equine anterior segment}, volume={12}, ISSN={1463-5216 1463-5224}, url={http://dx.doi.org/10.1111/j.1463-5224.2008.00688.x}, DOI={10.1111/j.1463-5224.2008.00688.x}, abstractNote={AbstractOcular photographs are an increasingly important method of documenting lesions for inclusion in medical records, teaching purposes, and research. Availability of affordable high‐quality digital imaging equipment has allowed for enhanced capture of desired images because of immediate on‐camera viewing and editing. Conversion of the standard digital camera sensor to one that is sensitive to infrared light (i.e. > 760 nm < 1 mm wavelength) can be done inexpensively. In the equine eye, advantages of infrared digital photography include increased contrast of anterior segment images, identification and monitoring of pigmentary changes, and increased visualization of the anterior segment through a cloudy or edematous cornea.}, number={2}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={McMullen Jr., Richard J. and Clode, Alison B. and Gilger, Brian C.}, year={2009}, month={Mar}, pages={125–131} }
 @article{gilger_clode_miller_mcmullen_2008, title={Letter to the Editor}, volume={11}, ISSN={1463-5216 1463-5224}, url={http://dx.doi.org/10.1111/j.1463-5224.2008.624_1.x}, DOI={10.1111/j.1463-5224.2008.624_1.x}, abstractNote={Veterinary OphthalmologyVolume 11, Issue 3 p. 207-207 Letter to the Editor Brian Gilger, Brian Gilger Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorAlison Clode, Alison Clode Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorTammy Miller, Tammy Miller Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorRichard McMullen, Richard McMullen Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this author Brian Gilger, Brian Gilger Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorAlison Clode, Alison Clode Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorTammy Miller, Tammy Miller Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this authorRichard McMullen, Richard McMullen Department of Clinical Sciences, North Carolina State University Raleigh, NC USASearch for more papers by this author First published: 23 April 2008 https://doi.org/10.1111/j.1463-5224.2008.624_1.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume11, Issue3May/June 2008Pages 207-207 RelatedInformation}, number={3}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={Gilger, Brian and Clode, Alison and Miller, Tammy and McMullen, Richard}, year={2008}, month={May}, pages={207–207} }
 @article{mcmullen_gilger_2006, title={Keratometry, biometry and prediction of intraocular lens power in the equine eye}, volume={9}, ISSN={1463-5216 1463-5224}, url={http://dx.doi.org/10.1111/j.1463-5224.2006.00493.x}, DOI={10.1111/j.1463-5224.2006.00493.x}, abstractNote={AbstractObjectiveTo determine ocular dimensions (A‐ and B‐scan ultrasound) and corneal curvature (radius of corneal diameter determined in B‐scan ultrasound) in the equine eye and to calculate the appropriate dioptric power for a posterior chamber intraocular lens (IOL) necessary to achieve emmetropia in the eyes of horses undergoing lens extraction.Animals Fourteen clinically normal adult horses of various breeds. Additionally, for comparison, one American Miniature colt foal, and one 2.5‐year‐old Shire gelding were examined.Procedure B‐scan ultrasound was performed on one eye from each horse. One eye from both the Shire and the American Miniature were examined for comparison. Data from ultrasound (globe measurements and corneal curvature), and the estimated postoperative IOL positions were entered into theoretical IOL formulas (Binkhorst and Retzlaff theoretical formulas) in order to calculate the predicted IOL strength required to achieve emmetropia after lens extraction in horses.Results Mean axial length of globes was 39.23 mm ± 1.26 mm, mean preoperative anterior chamber depth (ACD) was 5.63 ± 0.86 mm, and mean lens thickness was 11.75 ± 0.80 mm. Predicted postoperative ACD (PACD) was calculated as the ACD plus 50% of the lens thickness. Additionally, PACD 2 mm anterior and 2 mm posterior to the center of the lens were calculated in order to evaluate the effect of IOL position on its required refractive power. Required IOL strength calculated, using the three values for the predicted postoperative ACD, was 29.91 D ± 2.50, 29 D ± 2.52 (center of lens); 27.13 D ± 2.27, 26.33 D ± 2.20 (2 mm anterior to center of lens); and 33.18 D ± 2.78, 32.24 D ± 2.68 (2 mm posterior to center of lens) with the Binkhorst and Retzlaff theoretical formulas, respectively.Conclusions An IOL of substantially lower diopter strength than that needed in either dogs or cats is required to achieve emmetropia after lens extraction in adult horses. IOL strength of approximately 30 D, depending on where the IOL ultimately comes to rest, will probably be required.}, number={5}, journal={Veterinary Ophthalmology}, publisher={Wiley}, author={McMullen, Richard J. and Gilger, Brian C.}, year={2006}, month={Sep}, pages={357–360} }