The fetal membrane is composed by the chorion, allantois and amnion. The AM is the inner layer. It consists of a single layer of ectodermally derived cuboidal to columnar cells, which form the epithelium, a basement membrane that connects with the chorion by a layer of mesenchyme which contains large amounts of collagen (stroma). Amniotic basement membrane and stroma contain cytokines, proteoglycans, collagen type I, III, IV, V and VII, laminin and fibronectin. Different interesting properties of the AM have been described. Amniotic basement membrane, by serving as a “transplanted basement membrane”, acts as a new healthy substrate that facilitates migration of epithelial cells, reinforces adhesion of basal epithelial cells, promotes epithelial differentiation, and prevents epithelial apoptosis. Additionally AM produces various growth factors, inhibits protease activity, has anti-inflammatory, anti-angiogenic and antifibrotic effects. The non-immunogenicity of the AM was believed to be another important property. AM transplantation (AMT) has been widely described in human ophthalmology for the reconstruction of corneal and/or conjunctival surface in different diseases, such as: ocular surface neoplasia, pterygium, chemical and thermal burns, cicatrizing conjunctivitis, symblepharon release, bleb leakage, filtering surgery, persistent epithelial defects, non healing stromal ulcers, deep stromal ulcers and descemetoceles, neurotrophic keratopathy, limbal stem cells deficiency, bullous keratopathy, infectious keratitis, Stevens Johnson syndrome, melting ulcers, scleral melt and band keratopathy. In veterinary ophthalmology AMT has been described for the treatment of ocular surface neoplasia, bullous keratopaty, melting ulcers, symblepharon, immun-mediated keratitis and in conjunction with penetrating keratoplasty. The objective of our study was to evaluate the effects of amniotic membrane transplantation for reconstruction of the ocular surface in different diseases in dogs, cats and horses. We evaluated the cosmesis and visual function. In our case series we performed AMT with the inlay technique in 3 dogs (3 eyes), 6 cats (7 eyes) and 11 horses (11 eyes). The diseases treated were: 7 feline corneal sequestra, 4 corneal melting (1 dog and 3 horses), 2 dermoids (2 dogs), 4 keratomycosis (4 horses), 2 corneo-conjunctival squamous cell carcinoma (2 horses), 1 immunomediate keratitis (1 horse) and 1 corneal edema (1 horse). In our results the objective was obtained: we had successful outcome in 17 of the 21 eyes treated; no ocular pain was detected in the immediately postoperative period, the AM epithelialized quickly and, after the fibrovascular invasion of the AM, all the corneas obtained a good transparency and no recurrence was detected in our follow-up periods.

AMNIOTIC MEMBRANE TRANSPLANTATION FOR OCULAR SURFACE RECONSTRUCTION IN VETERINARY MEDICINE / L. Barachetti ; Tutor: Carlo Maria Mortellaro ; Coordinator: Angelo Belloli. Universita' degli Studi di Milano, 2010 Dec 15. 23. ciclo, Anno Accademico 2010. [10.13130/barachetti-laura_phd2010-12-15].

AMNIOTIC MEMBRANE TRANSPLANTATION FOR OCULAR SURFACE RECONSTRUCTION IN VETERINARY MEDICINE

L. Barachetti
2010

Abstract

The fetal membrane is composed by the chorion, allantois and amnion. The AM is the inner layer. It consists of a single layer of ectodermally derived cuboidal to columnar cells, which form the epithelium, a basement membrane that connects with the chorion by a layer of mesenchyme which contains large amounts of collagen (stroma). Amniotic basement membrane and stroma contain cytokines, proteoglycans, collagen type I, III, IV, V and VII, laminin and fibronectin. Different interesting properties of the AM have been described. Amniotic basement membrane, by serving as a “transplanted basement membrane”, acts as a new healthy substrate that facilitates migration of epithelial cells, reinforces adhesion of basal epithelial cells, promotes epithelial differentiation, and prevents epithelial apoptosis. Additionally AM produces various growth factors, inhibits protease activity, has anti-inflammatory, anti-angiogenic and antifibrotic effects. The non-immunogenicity of the AM was believed to be another important property. AM transplantation (AMT) has been widely described in human ophthalmology for the reconstruction of corneal and/or conjunctival surface in different diseases, such as: ocular surface neoplasia, pterygium, chemical and thermal burns, cicatrizing conjunctivitis, symblepharon release, bleb leakage, filtering surgery, persistent epithelial defects, non healing stromal ulcers, deep stromal ulcers and descemetoceles, neurotrophic keratopathy, limbal stem cells deficiency, bullous keratopathy, infectious keratitis, Stevens Johnson syndrome, melting ulcers, scleral melt and band keratopathy. In veterinary ophthalmology AMT has been described for the treatment of ocular surface neoplasia, bullous keratopaty, melting ulcers, symblepharon, immun-mediated keratitis and in conjunction with penetrating keratoplasty. The objective of our study was to evaluate the effects of amniotic membrane transplantation for reconstruction of the ocular surface in different diseases in dogs, cats and horses. We evaluated the cosmesis and visual function. In our case series we performed AMT with the inlay technique in 3 dogs (3 eyes), 6 cats (7 eyes) and 11 horses (11 eyes). The diseases treated were: 7 feline corneal sequestra, 4 corneal melting (1 dog and 3 horses), 2 dermoids (2 dogs), 4 keratomycosis (4 horses), 2 corneo-conjunctival squamous cell carcinoma (2 horses), 1 immunomediate keratitis (1 horse) and 1 corneal edema (1 horse). In our results the objective was obtained: we had successful outcome in 17 of the 21 eyes treated; no ocular pain was detected in the immediately postoperative period, the AM epithelialized quickly and, after the fibrovascular invasion of the AM, all the corneas obtained a good transparency and no recurrence was detected in our follow-up periods.
15-dic-2010
Settore VET/09 - Clinica Chirurgica Veterinaria
MORTELLARO, CARLO MARIA
BELLOLI, ANGELO
Doctoral Thesis
AMNIOTIC MEMBRANE TRANSPLANTATION FOR OCULAR SURFACE RECONSTRUCTION IN VETERINARY MEDICINE / L. Barachetti ; Tutor: Carlo Maria Mortellaro ; Coordinator: Angelo Belloli. Universita' degli Studi di Milano, 2010 Dec 15. 23. ciclo, Anno Accademico 2010. [10.13130/barachetti-laura_phd2010-12-15].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/150198
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