Comparação do Tacrolimus 0.03% tópico e Plasma Rico em Plaquetas Homólogo injetável no tratamento de ceratoconjuntivite seca em cães

Abstract

The aim of the study was to compare the conventional use of the topical immunosuppressant tacrolimus 0.03% eye drops with the injectable homologous platelet-rich plasma (HPRP) in dogs with keratoconjunctivitis sicca (KCS). Sixty-six eyes were evaluated, 22 eyes from the negative control group (NCG) coming from the Unoeste kennel, 22 eyes from the tacrolimus group (TG) and 22 eyes from the homologous platelet-rich plasma group (HPRPG) without breed, age or sexual predilection attended by the ophthalmology sector Veterinary Hospital of the Unoeste and diagnosed with KCS. The TG received topical 0.03% tacrolimus eye drops, 1 drop in both eyes, twice a day, and the HPRPG received an injectable application of 0.3 ml of HPRP, 0.1 ml in the lower palpebral conjunctiva, 0.1 ml in the upper and 0.1 ml in the third eyelid gland, once every 30 days, as signs of KCS improve, totaling a maximum of three applications. The animals were evaluated monthly for 6 months for clinical signs and specific ophthalmic tests: Shirmer's Tear Test-1 (STT-1), Osmolarity Test (OT), Strip meniscometry test (SMT), Tear Film Break-up Test (TBUT), Fluorescein Test (FT) and Lyssamine Green Test (LGT). The HPRPG, of the 11 dogs (n=22 eyes) treated, the required number of applications that improved the initial ocular signs was: 36% (4 dogs) received 3 applications, 55% (6 dogs) received 2 applications, and 9% (1 dog) received 1 application. The ocular signs of pigmentation, corneal ulcer and neovascularization, ocular secretion and conjunctival hyperemia showed improvement in both groups by the end of the study. In the TG, by the end of the study, there was a significant increase (p<0.05) greater than the TG in the values of STT-1, SMT and count of goblet cells of the palpebral conjunctiva. In HPRPG there was a significant decrease (p<0.05) greater than in TG in the count of lymphocytes and neutrophils of the palpebral conjunctiva. In TBUT and TOT there was a significant increase (p<0.05) of values until the end, with equal performance of TG and HPRPG. In the FT and LGT, at the end of the study were all negative, with an earlier negative of the FT on the TG, and equal performance of the LGT in both groups. In general, both groups were equivalent in the improvement of TBUT, OT and LGT parameters. Tacrolimus 0.03% eye drops proved to be more efficient in increasing tear production and the number of goblet cells than HPRP. However, injectable HPRP proved to be more efficient than TG in decreasing conjunctival inflammatory cells. We concluded that the injectable use of homologous PRP requires an average of 2 to 3 monthly applications, is safe and feasible on an ambulatory care level, more financially viable than tacrolimus, and can be used as a more accessible alternative therapy or suggested as an adjuvant to conventional treatment with topical immunosuppressants.