Abstract
Purpose :
To report safety and tolerability of a one-time application of 5% povidone-iodine (PVP-I) for the treatment of adenoviral conjunctivitis (Ad-Cs) in the RAPID study, a pilot double-masked, randomized trial of PVP-I versus artificial tears (AT).
Methods :
Eligible, consenting participants were randomized to receive a one-time, in-office administration of either 5% PVP-I or AT on baseline day 0. After 2 minutes, the ocular surface was lavaged with sterile saline irrigation solution. Participant-reported discomfort and corneal fluorescein staining were assessed before, immediately after instillation, and 1-2 days after treatment. Participants rated discomfort from 0 (not at all) to 10 (very bothersome). Fluorescein staining was graded from 0 “none” to 4 “patch” in 5 corneal zones. Snellen visual acuity converted to logMAR, slit lamp biomicroscopy findings, participant rated symptoms, and adverse events were assessed at day 0 before instillation, and on days 1-2, 4, 7, 14 and 21.
Results :
Of 212 patients screened for presumptive Ad-Cs across 9 USA based centers, 56 were randomized (PVP-I: n=30; AT: n=26). In the AT group, participant-reported discomfort decreased immediately post-instillation from 6.7 ± 2.6 to 3.3 ± 2.8 (n=26; p<0.01). Participant-reported discomfort in the PVP-I group did not change immediately post-instillation (6.0 ± 3.0 to 6.2 ± 2.8; n=30; p= 0.8). In the AT group, there was no change in corneal staining from pre- to immediate post-instillation or day 1-2 days. In the PVP-I group, immediate post-instillation corneal staining increased significantly (p<0.01) and returned to pre-treatment levels by day 1-2. No differences between PVP-I and AT groups were detected in visual acuity, slit lamp findings or participant reported symptoms at day 1-2 from pre-instillation levels. One adverse event of light sensitivity with mild anterior chamber reaction was recorded on the day 1-2 visit in the PVP-I group.
Conclusions :
Overall, there was not an increase in participant-reported ocular discomfort after treatment with ophthalmic 5% PVP-I. There was an increase in corneal staining immediately post-treatment with 5% PVP-I that returned to pre-treatment levels by the day 1-2 visit. These results suggest 5% PVP-I is safe and well tolerated by patients with Ad-Cs.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.