July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
The Reducing Adenoviral Patient-Infected Days (RAPID) Study: Safety and Tolerability of One-Time, In-Office Application of 5% Povidone-Iodine in the Treatment of Adenoviral Conjunctivitis
Author Affiliations & Notes
  • Ellen Shorter
    Ophthalmology and Vision Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Tammy Than
    Carl Vinson VAMC, Georgia, United States
  • Meredith Whiteside
    UC Berkeley, California, United States
  • Jennifer S Harthan
    Illinois College of Optometry, Illinois, United States
  • Mathew Margolis
    Washington University in St. Louis, Missouri, United States
  • Spencer Johnson
    Northeastern State University, Oklahoma, United States
  • Mary Migneco
    Washington University in St. Louis, Missouri, United States
  • Christina Morettin
    Illinois College of Optometry, Illinois, United States
  • Christian K. Olson
    Fort Sam Houston, Texas, United States
  • Andrew Hartwick
    Ohio State University, Ohio, United States
  • Julia Huecker
    Washington University in St. Louis, Missouri, United States
  • Mae O Gordon
    Ohio State University, Ohio, United States
  • Footnotes
    Commercial Relationships   Ellen Shorter, None; Tammy Than, None; Meredith Whiteside, None; Jennifer Harthan, None; Mathew Margolis, None; Spencer Johnson, None; Mary Migneco, None; Christina Morettin, None; Christian K. Olson, None; Andrew Hartwick, None; Julia Huecker, None; Mae Gordon, None
  • Footnotes
    Support  This work was supported by a National Eye Institute Center R34 Grant (EY023633-01A1), a National Eye Institute Center Core Grant (P30EY002687) and an unrestricted grant to the Department of Ophthalmology and Visual Sciences from Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4703. doi:https://doi.org/
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      Ellen Shorter, Tammy Than, Meredith Whiteside, Jennifer S Harthan, Mathew Margolis, Spencer Johnson, Mary Migneco, Christina Morettin, Christian K. Olson, Andrew Hartwick, Julia Huecker, Mae O Gordon; The Reducing Adenoviral Patient-Infected Days (RAPID) Study: Safety and Tolerability of One-Time, In-Office Application of 5% Povidone-Iodine in the Treatment of Adenoviral Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4703. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

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