[Adenoviral keratoconjunctivitis].
Keratoconjunctivitis caused by adenoviruses (epidemic keratoconjunctivitis, EKC, ICD-10 B30.0+) is common, can be severe and may cause significant morbidity. In the early stages of adenoviral infections it is often difficult to differentiate the clinical presentation from other causes of a red eye. Because of its highly contagious nature that can rapidly lead to epidemic outbreaks, prompt viral identification and prevention of further spread are major challenges. Even today the diagnosis is still mainly clinical, with laboratory tests only rarely contributing. New diagnostic tests, such as the Rapid Pathogen Detector (RPS, Sarasota FL) AdenoPlus detection kit, that are practical, rapid and inexpensive to use in the general practice may obviate these problems. Because of its highly resistant properties to desiccation and highly developed escape mechanisms which protect the virus from the host's immune response, long-term problems often remain. Remnants of viral proteins often persist on the corneal surface of Bowman's layer for a long time and may lead to the formation of subepithelial infiltrates. No treatment other than symptomatic eye drops is available. The major sequelae are subepithelial infiltrates, which are difficult to treat. Cyclosporin A eye drops are a good option with a low risk profile. The use of topical steroids can possibly be disadvantageous but can be discussed at all stages of the disease. As nosocomial spread of adenoviruses is relatively common, preventive measures remain a major responsibility for ophthalmologists.
Charité, Augenklinik, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland, uwe.pleyer@charite.de.
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D000257:Adenoviridae Infections / Q000175:diagnosis* / Q000517:prevention & control*; D016572:Cyclosporine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D007637:Keratoconjunctivitis / Q000175:diagnosis* / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D016896:Treatment Outcome
D009883:Ophthalmic Solutions; D016572:Cyclosporine