Treatment of adenoviral keratoconjunctivitis with a combination of povidone-iodine 1.0% and dexamethasone 0.1% drops: a clinical prospective controlled randomized study

Acta Ophthalmol. 2017 Dec;95(8):e686-e692. doi: 10.1111/aos.13416. Epub 2017 Mar 25.

Abstract

Purpose: To determine the efficacy of combination povidone-iodine (PVP-I) 1.0% eyedrops and dexamethasone 0.1% eyedrops in the treatment of adenoviral keratoconjunctivitis.

Materials and methods: In a prospective, randomized, controlled, double-blinded clinical trial patients with recent adenoviral keratoconjunctivitis (diagnosed clinically and confirmed by PCR), we randomly divided into three treatment groups: study group - received PVP-I 1.0% and dexamethasone 0.1%, control 1 group - received dexamethasone 0.1% and control 2 group - received lubricating eyedrops (hypromellose 0.3%). The treatment was administered four times a day in each group. All patients were examined and filled a questionnaire before treatment and on the 3rd, 5th and 7th days of treatment.

Results: We included in the study 78 eyes (26 in each group). Adenovirus type 8 was the most common pathogen (83% of cases). The fastest improvement in patients red eyes, discharge, superficial punctate keratitis and pseudomembranes was observed in the study group (p < 0.001). Those patients reached a near complete recovery in 5-7 days, which was also confirmed by reduction in Adenovirus titres by PCR. The slowest improvement was in the control 2 group. Subepithelial infiltrates (SEI) were observed in 44% of the control 1 group, 20% of the control 2 group and in 0% of the study group. The rate of reduction in Adenovirus titres was the slowest in the control 1 group.

Conclusion: The combination of PVP-I 1.0% and dexamethasone 0.1% four times a day can reduce symptoms and expedite recovery in epidemic keratoconjunctivitis patients.

Keywords: adenoviral keratoconjunctivitis; conjunctivitis; dexamethasone; povidone-iodine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adenoviridae / genetics
  • Adenoviridae Infections / drug therapy*
  • Adenoviridae Infections / virology
  • Adult
  • Anti-Infective Agents, Local / administration & dosage
  • DNA, Viral / analysis
  • Dexamethasone / administration & dosage*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Therapy, Combination
  • Eye Infections, Viral / drug therapy*
  • Eye Infections, Viral / virology
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Humans
  • Keratoconjunctivitis / drug therapy*
  • Keratoconjunctivitis / virology
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Povidone-Iodine / administration & dosage*
  • Prospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • DNA, Viral
  • Glucocorticoids
  • Ophthalmic Solutions
  • Dexamethasone
  • Povidone-Iodine