Louisiana State University LSU Digital Commons LSU Master's Theses Graduate School 2012 Role of Intraocular Leptospira Infections in the Pathogenesis of Equine Recurrent Uveitis in the Southern United States Florence Polle Louisiana State University and Agricultural and Mechanical College, [email protected] Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_theses Part of the Veterinary Medicine Commons Recommended Citation Polle, Florence, "Role of Intraocular Leptospira Infections in the Pathogenesis of Equine Recurrent Uveitis in the Southern United States" (2012). LSU Master's Theses. 3492. https://digitalcommons.lsu.edu/gradschool_theses/3492 This Thesis is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Master's Theses by an authorized graduate school editor of LSU Digital Commons. For more information, please contact [email protected]. ROLE OF INTRAOCULAR LEPTOSPIRA INFECTIONS IN THE PATHOGENESIS OF EQUINE RECURRENT UVEITIS IN THE SOUTHERN UNITED STATES A Thesis Submitted to the Graduate Faculty of the Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Master of Science In The School of Veterinary Medicine Through The Department of Veterinary Clinical Sciences By Florence Polle DrMedVet, Ecole Nationale Vétérinaire de Toulouse, 2007 August 2012 To my parents, who always let me make my own choices. ii ACKNOWLEDGMENTS My deepest gratitude to the members of my committee, Drs. Renee Carter, Susan Eades and Rebecca McConnico, for their guidance and support during the realization of this study and the preparation of this manuscript. For performing statistical analysis, I would like to thank Drs. Hugues Beaufrere and Michael Kearney. For performing all the cultures and graciously proving the media, I would like to thank Drs. Richard Hornsby, David Alt and Richard Zuerner from the National Centers for Animal Health in Aimes, Iowa. I would also like to thank Mike Keowen and Tommy Stevens for their time and assistance with the horses, and for helping me getting donation for this project. Thank you to the Veterinary Clinical Science and the Equine Health and Study Program for funding this work. Last, I would like to thank Dr. Susan Eades for her invaluable guidance and mentorship during the past three years. iii TABLE OF CONTENTS DEDICATION ................................................................................................................................. ii ACKNOWLEDGMENTS ............................................................................................................... iii LIST OF TABLES .......................................................................................................................... vi LIST OF FIGURES ........................................................................................................................ vii ABSTRACT .................................................................................................................................. viii INTRODUCTION............................................................................................................................ 1 CHAPTER ONE. REVIEW OF THE LITERATURE .................................................................... 2 1.1. The normal equine eye ........................................................................................................ 2 1.1.1. The uvea ................................................................................................................... 2 1.1.2. Normal immunology ................................................................................................. 3 1.2. Epidemiology of Equine Recurrent Uveitis ....................................................................... 4 1.2.1. Prevalence ................................................................................................................. 4 1.2.2. Breed and genetic susceptibility ............................................................................... 4 1.2.3. Age and sex .............................................................................................................. 5 1.2.4. Etiology .................................................................................................................... 5 1.3. Diagnosis and clinical signs ............................................................................................... 6 1.3.1. Clinical presentation ................................................................................................. 6 1.3.2. Additional tests ......................................................................................................... 7 1.3.3. Pathology of ERU ..................................................................................................... 9 1.4. Treatment, prevention and prognosis of ERU ................................................................... 9 1.4.1. Medical treatment ................................................................................................... 10 1.4.1.1.Anti-inflammatory drugs ............................................................................... 10 1.4.1.2.Cycloplegics and mydriatics ......................................................................... 10 1.4.1.3.Antibiotics ..................................................................................................... 11 1.4.1.4.Other .............................................................................................................. 11 1.4.1.5.Limitations .................................................................................................... 12 1.4.2. Surgical treatment ................................................................................................... 12 1.4.2.1.Vitrectomy ..................................................................................................... 12 1.4.2.2.Cyclosporine implants ................................................................................... 13 1.4.2.3.Other .............................................................................................................. 14 1.4.3. Vaccination ............................................................................................................. 15 1.4.4. Prognosis ................................................................................................................ 15 1.5. Immunology of ERU ........................................................................................................ 16 1.5.1. Targeted autoantigens ............................................................................................. 17 1.5.2. Molecular mimicry ................................................................................................. 17 1.5.3. Differentially regulated candidates in uveitis target tissues ................................... 18 1.6. Leptospirosis and ERU ................................................................................................... 18 1.6.1. Leptospirosis ........................................................................................................... 18 1.6.1.1.Bacteriology .................................................................................................. 18 iv 1.6.1.2.Diagnostic testing .......................................................................................... 19 1.6.1.3.Leptospirosis in horses .................................................................................. 20 1.6.2. Leptospiral uveitis in human medicine ................................................................... 21 1.6.3. Evidence for leptospirosis as a cause of ERU ........................................................ 22 1.6.3.1.Europe ........................................................................................................... 23 1.6.3.2.North America ............................................................................................... 24 1.6.3.3.Other .............................................................................................................. 24 CHAPTER TWO. ROLE OF INTRAOCULAR LEPTOSPIRA INFECTIONS IN THE PATHOGENESIS OF EQUINE RECURRENT UVEITIS IN THE SOUTHERN UNITED STATES ......................................................................................................................................... 26 2.1. Materials and methods .................................................................................................... 26 2.2. Results ............................................................................................................................. 28 2.2.1. Horses ..................................................................................................................... 28 2.2.2. Ophthalmic examination ........................................................................................ 29 2.2.3. Histological findings .............................................................................................. 33 2.2.4. Serology ................................................................................................................. 36 2.2.5. Culture .................................................................................................................... 37 2.2.6. Real-Time PCR .....................................................................................................