Abstract
Purpose :
Immunochromatography (IC) kit is widely used for the diagnosis of adenoviral conjunctivitis, but this needs conjunctival scraping for material collection. In this study, we evaluated a novel adenovirus (AdV) detection kit that used tears including conjunctival exudate without conjunctival scraping in comparison with a conventional IC kit.
Methods :
Two kinds of rapid diagnosis kits were used on 93 cases who visited Fukuoka University Hospital Eye Center or Migita Eye Clinic between July 2017 and November 2017 and were suspected for adenoviral conjunctivitis. The first kit (control kit) was a conventional IC kit for conjunctival scrapings. The other kit (test kit) was also an IC kit, but a physician pressed a filter paper strip on conjunctiva to collect tear including conjunctival exudate sample and the result was automatically obtained by specific reader which was based on silver amplification method in 15 minutes. The detection of AdV was carried out by real-time polymerase chain reaction method and its typing was done by direct sequencing. Comparative dilution test was carried out for clinical strains of AdV types 3, 53 and 54 using both IC tests.
Results :
AdV type 54 was detected in 55 eyes, and type 3 and type 19/64 was detected in 2 eyes, respectively. Sensitivity of control kit and test kit was 89.8% and 98.3%, respectively. Specificity of both kit was 100%. Significant difference was observed in the sensitivities of the two IC kits against PCR positivity (P<0.01). In the time-dependent comparison, test kit showed positivity until 6 days after the onset of adenoviral conjunctivitis, whereas control kit showed positivity until 4 days. In the dilution sensitivity test, test kit showed 32 times better sensitivity for AdV type 3, 64 times for AdV type 53 and type 54 compared to control kit.
Conclusions :
It was suggested that amplified AdV detecting kit using tears including conjunctival exudate was useful clinically because it needs no scraping of conjunctiva and patients feel less discomfort in specimen collection, and its sensitivity was significantly higher than that of the conventional IC kit and its results were highly objective, however it is necessary to provide a dedicated reader for this test.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.