Abstract
Abstract: :
Purpose:To determine if adenoviral DNA persists in the tear film post adenoviral keratoconjunctivitis (AKC) and whether this relates to the persistence or recurrence of ocular disease. Methods: Sixty-six patients with previous culture positive AKC were questioned of whom 31 were available for examination. Ocular symptoms, history or development of post AKC atopy were assessed and related to a tarsal conjunctival papillae score. Tear specimens were collected for the presence of adenovirus and adenoviral DNA. Thirty-three subjects with no known history of AKC were included controls. Results: A history AKC was associated with an increased incidence a papillary conjunctivitis indistinguishable from atopic conjunctivitis. The presence of papillae was associated with ocular symptoms, regardless of the patient's prior atopic status. There was no significant difference in outcome post AKC between patients who had a prior history of atopic disease. In the control group, ocular symptoms and signs were were more common in subjects with a history of atopy. Adenoviral DNA was detected in 19 patients, and was found significantly more frequently in patients who were symptomatic (p=0.006) and who had a presistent papillary conjunctivitis (p=0.04). A history of atopy did not predispose to the persistence of adenoviral DNA in the tear film (p=0.07). Conclusion:AKC predisposes to the development of a recurrent or persistent papillary conjunctivitis. This appears related to the persistence of adenoviral DNA in the tear film.
Keywords: 307 adenovirus • 366 conjunctivitis • 352 clinical (human) or epidemiologic studies: natural history