The role of Leptospira spp. in horses affected with recurrent uveitis in the UK

BACKGROUND: Equine recurrent uveitis (ERU) is a common cause of ocular pain and blindness in horses. Leptospira spp. have been commonly implicated in the pathophysiology of ERU in mainland Europe and the USA. No recent studies have been carried out in the UK, but Leptospira is reported not to be a major factor in the aetiology of ERU in the UK. OBJECTIVES: To establish the prevalence of Leptospira‐associated ERU in the UK and to identify the serovars involved in these cases; to compare serum vs. aqueous humour antibody levels in cases and controls in order to confirm the diagnosis of Leptospira‐associated ERU, and to assess the usefulness of serology alone as a confirmatory test for Leptospira‐associated ERU in the UK. STUDY DESIGN: Case–control study. METHODS: Eyes enucleated for clinical reasons in ERU‐affected horses were collected. Blood and aqueous humour were obtained to determine antibody levels against a variety of Leptospira serovars and C‐values (aqueous humour value/serum value) were calculated. In addition, eyes, blood and aqueous humour were obtained from control cases for comparison. Histopathology was performed in all eyes to confirm uveitis in each case. Differences in seroprevalences between ERU and control cases and between Leptospira‐ and non‐Leptospira‐associated ERU cases were calculated. RESULTS: A total of 30 ERU and 43 control eyes were analysed. Of the ERU eyes, only two had a C‐value of >4 (prevalence of Leptospira‐associated uveitis: 6.7%). Serovars hardjo and javanica were detected. There was no difference in seroprevalence between horses with uveitis and control cases (65.5% and 41.9%, respectively; P = 0.11) or between Leptospira‐ and non‐Leptospira‐associated uveitis cases (100% and 63.0%, respectively; P = 0.52). MAIN LIMITATIONS: The study was limited by low case numbers. Eyes were presented at different stages of disease. The only test used to detect Leptospira was the microscopic agglutination test. CONCLUSIONS: Leptospira‐associated ERU is uncommon in the UK. Serology alone may not help to definitively diagnose Leptospira‐associated uveitis in this country.