马角膜炎的治疗,第 1 部分:根据临床表现和诊断检测选择适当的治疗方法可提高临床疗效。

IF 1.6 2区 农林科学 Q2 VETERINARY SCIENCES
Hannah L Smith, Kim R Love, Ariana Antezana, Erin M Barr, Brian C Gilger, Annie Oh
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引用次数: 0

摘要

目的确定接受角霉菌病治疗的马匹的临床结果、治疗费用和住院时间,并确定与这些结果相关的眼科检查和诊断结果:这是一项回顾性研究,研究对象为 2004 年至 2020 年间 126 例经细胞学、培养和/或组织病理学确诊为真菌感染且至少随访 1 个月的马角膜真菌病病例。详细记录了眼科检查、诊断测试结果、治疗和费用结果。相关结果按治疗类型进行分析。通过逻辑和线性回归模型确定患者和诊断测试变量与相关结果的关系:82.5%和78.9%的药物治疗病例以及88.4%和85.5%的手术治疗病例都获得了全球保留和积极的视觉效果。近年来,94.7%的穿透性角膜移植术后病例保留了眼球和视力,虽然没有统计学意义,但手术治疗的临床结果更为乐观。是否选择手术与病变深度有关。据统计,与所有手术治疗相比,药物治疗的住院时间更短,总费用和住院费用更低。与溃疡性角膜病相比,基质脓肿的诊断与较高的发票总额和较长的住院时间有关,尽管临床结果相似:结论:尽管许多病例的病情严重,但总体上取得了积极的临床疗效,这凸显了根据临床表现选择适当治疗方法的必要性:临床相关性:扩大对临床决策、治疗方案以及相关临床和财务结果的了解可进一步改善马角化病患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of equine keratomycosis, part 1: selection of appropriate therapy based on clinical presentation and diagnostic testing improves clinical outcomes.

Objective: To determine clinical outcome, treatment costs, and hospitalization duration in horses treated for keratomycosis and identify ophthalmic examination and diagnostic results associated with these outcomes.

Methods: This was a retrospective study of 126 equine keratomycosis cases between 2004 and 2020 with fungal infection confirmed on cytology, culture, and/or histopathology and a minimum of 1-month follow-up. Details of the ophthalmic examination, diagnostic test results, and treatment and cost outcomes were recorded. Outcomes of interest were analyzed by treatment type. The relationship of patient and diagnostic test variables to the outcomes of interest was determined via logistic and linear regression models.

Results: Globe retention and positive visual outcome occurred in 82.5% and 78.9% of medically and 88.4% and 85.5% of surgically treated cases, respectively. While not statistically significant, there were more positive clinical outcomes with surgery; in recent years, the globe and vision were preserved in 94.7% of cases following penetrating keratoplasty. The choice to pursue surgery was related to lesion depth. Medical treatment was associated with statistically shorter hospitalization times and lower total and hospitalization invoices compared to all surgical treatments. Diagnosis of stromal abscess was associated with higher total invoice and longer hospitalization times compared to ulcerative keratomycosis, although clinical outcomes were similar.

Conclusions: Overall positive clinical outcomes were achieved despite the severity of the disease in many cases, highlighting the need for appropriate treatment selection based on clinical presentation.

Clinical relevance: Expanding knowledge of clinical decision-making, treatment options, and associated clinical and financial outcomes may further improve outcomes for equine keratomycosis patients.

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来源期刊
CiteScore
1.60
自引率
15.80%
发文量
539
审稿时长
6-16 weeks
期刊介绍: Published twice monthly, this peer-reviewed, general scientific journal provides reports of clinical research, feature articles and regular columns of interest to veterinarians in private and public practice. The News and Classified Ad sections are posted online 10 days to two weeks before they are delivered in print.
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