Treatment of adenoviral keratoconjunctivitis with a combination of povidone-iodine 1.0% and dexamethasone 0.1% drops: a clinical prospective controlled randomized study.
OBJECTIVE
To determine the efficacy of combination povidone-iodine (PVP-I) 1.0% eyedrops and dexamethasone 0.1% eyedrops in the treatment of adenoviral keratoconjunctivitis.


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.


CONCLUSIONS
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.
Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.
Natalya
N
Kovalyuk
Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.|Department of health science, Ben Gurion University, Be'er Sheva, Israel.
Igor
I
Kaiserman
Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
Michael
M
Mimouni
Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.
Ornit
O
Cohen
Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.|Department of health science, Ben Gurion University, Be'er Sheva, Israel.
Shmuel
S
Levartovsky
Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel.
Hilda
H
Sherbany
Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel.|Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Michal
M
Mandelboim
D000208:Acute Disease; D000256:Adenoviridae / Q000235:genetics; D000257:Adenoviridae Infections / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D004279:DNA, Viral / Q000032:analysis; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015828:Eye Infections, Viral / Q000188:drug therapy* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007637:Keratoconjunctivitis / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D004279:DNA, Viral; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone; D011206:Povidone-Iodine
adenoviral keratoconjunctivitis; conjunctivitis; dexamethasone; povidone-iodine