Current therapy and advancements in the treatment of equine fungal keratitis

J Am Vet Med Assoc. 2024 Jul 11;262(S2):S65-S73. doi: 10.2460/javma.24.05.0337. Print 2024 Dec 1.

Abstract

Equine fungal keratitis represents a substantial portion of keratitis cases in horses, with fungal involvement identified in approximately half of all infectious keratitis cases. Despite its prevalence, more comprehensive retrospective analyses are needed to better understand this condition. Outcomes vary, with approximately two-thirds of cases achieving complete healing with retained vision, although enucleation is often necessary. Predominant pathogens include Aspergillus and Fusarium, with yeast reported in a minority of cases. Resistance to common antifungal agents among filamentous fungi poses a significant challenge. Advances in diagnostics, including repeat culture and antifungal susceptibility testing, as well as the incorporation of PCR technology, hold promise for improving detection and guiding treatment decisions. Newer antifungals, combination therapies, and innovative modalities such as photodynamic therapy offer hope for improved outcomes. Continued research efforts are essential to further elucidate the epidemiology, pathogenesis, and optimal management strategies for this condition.

Keywords: Aspergillus; Fusarium; azole; fungal keratitis; ulcerative keratitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Antifungal Agents* / therapeutic use
  • Eye Infections, Fungal* / drug therapy
  • Eye Infections, Fungal* / microbiology
  • Eye Infections, Fungal* / veterinary
  • Horse Diseases* / drug therapy
  • Horse Diseases* / microbiology
  • Horse Diseases* / therapy
  • Horses
  • Keratitis* / drug therapy
  • Keratitis* / microbiology
  • Keratitis* / veterinary

Substances

  • Antifungal Agents