ESCRS - FPM06.09 - Clinical And Laboratory (Pcr) Evaluation Of Different Treatment Methods Applied In Adenoviral Conjonctivitis And Comparison Of These Methods In Terms Of Effectiveness

Clinical And Laboratory (Pcr) Evaluation Of Different Treatment Methods Applied In Adenoviral Conjonctivitis And Comparison Of These Methods In Terms Of Effectiveness

Published 2022 - 40th Congress of the ESCRS

Reference: FPM06.09 | Type: Free paper | DOI: 10.82333/q7f7-ez95

Authors: Fahri Onur Aydin* 1 , Semra Akkaya Turhan 2 , Rabia Can Sarınoglu 3 , Aysegul Karahasan 3 , Ayfer Güner 3 , Ayse Ebru Toker 2

1Departmen of ophthalmology,University of Health Sciences, Basaksehir Cam and Sakura City Hospital,Istanbul,Türkiye, 2Departmen of ophthalmology,Marmara University, School of Medicine,Istanbul,Türkiye, 3Department of Microbiology,Marmara University, School of Medicine,Istanbul,Türkiye

Purpose

To evaluate the efficacy of ganciclovir (GCV) oftalmic gel, povidone-iodine (PVP-I) %1 and their combinations with loteprednol etabonate (LE) eyedrops in the treatment of adenoviral keratoconjunctivitis.

Setting

Single tertiary hospital 

Methods

In this trial, patients with recent adenoviral keratoconjunctivitis (diagnosed clinically and with AdenoPlus test [Rapid Pathogen Screening Inc., Sarasota, Florida, USA] and then confirmed by PCR) were divided into five groups. Control group received artificial tears; study groups received PVP-I %1, GCV, PVP-I %1+LE, and GCV+LE. All patients were examined and conjunctival swab samples  for PCR analysis were collected before treatment and on the 4th, 7th, 10th, 14th days of treatment. A questionnaire was used to grade the symptoms during follow up. Infiltrates were recorded on the 30th day of treatment. Efficacy measures included clinical resolution and adenoviral eradication rates, and frequency of pseudomembrane formation and infiltrates.

Results

Seventy five eyes of 75 patients were included in the study. There was no significant difference between the groups in terms of age and gender (p>0.05). Adenovirus type 8 was the most common pathogen (%95). No significant differences were found between the groups in the terms of clinical findings and symptoms (p>0.05). The fastest reduction of adenovirus titers in early phase of the disease was observed in the PVP-I %1 group (p=0.036). The fastest improvement of the clinical findings and symptoms was observed in the PVP-I+LE group (p=0.047, p=0.026, p=0.040). Formation of pseudomembrane was similar between the groups, but subephitelial infiltrates were observed significantly low in the PVP-I+LE group (p=0.003).

Conclusions

GCV had no effect neither the clinical findings and symptoms nor the viral shedding. Combination of PVP-I and LE provided a significant improvement in the clinical findigs and symptoms, while the viral shedding was not prolonged and also the formation of subepithelial infiltrates was reduced. Therefore it appeared safe and well tolerated in adenoviral keratoconjuntivitis.