Comparison of clinical outcome with different treatment regimens in acute adenoviral keratoconjunctivitis

Abstract

Purpose To compare the clinical outcome with different treatment regimens in Acute Adenoviral Keratoconjunctivitis (AAK).

Methods The records of 110 patients diagnosed as AAK in two tertiary eye care centers were evaluated retrospectively. The treatment regimen, follow-up duration, time until improvement of the symptoms, visual acuity, clinical findings, Schirmer's test and the Ocular Surface Disease Index (OSDI) score at the first day, first week and third week were recorded. The Kruskal-Wallis Test and Chi-square test were used for comparison of quantitative and categorical variables, respectively.

Results Forty six patients were receiving topical corticosteroids (Group 1), 32 topical 2% Cyclosporin A (CsA) (Group 2) and 32 only artificial tears (Group 3). Mean time until resolution of the symptoms was lowest in Group 1 (9.5 +/- 4.9 days) and highest in Group 3 (13.3 +/- 4.2 days)(p: 0.001). OSDI scores at the first and third weeks were highest in Group 3 (52.4 +/- 16.4 and 32.3 +/- 13.0) and lowest in Group 1 (41.0 +/- 21.3 and 23.9 +/- 13.2)(p: 0.01 and p: 0.009). At day 21, percentage of the patients with subepthelial infiltrates was the highest in Group 3 (63.4%) and lowest in Group 1 (42.5%).

Conclusions The symptoms were less severe and had a shorter duration with topical corticosteroids and CsA when compared with palliative therapy. Topical 2% CsA may inhibit development of corneal subepithelial infiltrates when used in the acute phase of infection, similar to corticosteroids.