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K.F. Tabbara, E.F. Hammouda, K. Aoki, I. Takahashi, N. Mizuki, S. Ohno; Adenoviral Keratoconjunctivitis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4651.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the types of adenoviral infections and to correlate the severity of the complications with the type of adenovirus. Methods: We studied patients who presented to The Eye Center, Riyadh, Saudi Arabia, with viral keratocojunctivitis. Immunochromatography (IC) test was used to diagnose adenoviral keratoconjunctivitis, and conjunctival swabs were subjected to Giemsa staining and Adenovirus typing. We performed Hexon protein sequence homology between clinical samples and adenovirus by restriction fragment length polymorphism (RFLP). Clinical manifestations and findings were recorded for each patient. Results: A total of 31 patients with viral keratoconjunctivitis were studied. Twenty-one (68%) out of 31 patients revealed positive IC test. RFLP on patients with positive IC test showed adenovirus type 8 in 12 (56%) patients, type 37 in 4 (19%) patients, type 22 in two (10%) patients, and type 19 in one (5%) patient. Preauricular lymphnode was present in 83% of type 8, and 50% of type 37. Pseudomembranous conjunctivitis was present in 42% of type 8 and 50% of type 27. Superficial punctate keratitis and persistent nummular corneal opacities were associated with adenovirus type 8 and 19. Conjunctival scarring and dry eyes were seen following types 8 and 19, but not with adenovirus type 22. Conclusions: The most frequently encountered adenovirus in Saudi Arabia is type 8 followed by type 37, 22, 4 and 19, respectively. The clinical picture of adenovirus type 8 and 19 was associated with severe form of keratoconjunctivitis. Adenoviral infection with types 4, 22 and 37 caused mild follicular conjunctivitis without conjunctival or corneal complications.
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