July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Reducing Adenoviral Patient-Infected Days (RAPID) Study: A Randomized Trial Assessing Efficacy of One Time, In-Office Application of 5% Povidone-Iodine in Treatment of Adenoviral Conjunctivitis
Author Affiliations & Notes
  • Andrew Hartwick
    Optometry, Ohio State University, Columbus, Ohio, United States
  • Tammy Than
    Carl Vinson VAMC, Dublin, Georgia, United States
  • Bojana Rodic-Polic
    DiaSorin Molecular, Cypress, California, United States
  • Spencer Johnson
    Northeastern State University, Oklahoma, United States
  • Mary Migneco
    Washington University in St. Louis, Missouri, United States
  • Ellen Shorter
    University of Illinois, Illinois, United States
  • Jennifer S Harthan
    Illinois College of Optometry, Illinois, United States
  • Christina Morettin
    Illinois College of Optometry, Illinois, United States
  • Meredith Whiteside
    UC Berkeley, California, United States
  • Christian K. Olson
    Fort Sam Houston, Texas, United States
  • Mathew Margolis
    Washington University in St. Louis, Missouri, United States
  • Julia Huecker
    Washington University in St. Louis, Missouri, United States
  • Gregory Storch
    Washington University in St. Louis, Missouri, United States
  • Mae O Gordon
    Washington University in St. Louis, Missouri, United States
  • Footnotes
    Commercial Relationships   Andrew Hartwick, None; Tammy Than, None; Bojana Rodic-Polic, DiaSorin Molecular (E); Spencer Johnson, None; Mary Migneco, None; Ellen Shorter, None; Jennifer Harthan, None; Christina Morettin, None; Meredith Whiteside, None; Christian K. Olson, None; Mathew Margolis, None; Julia Huecker, None; Gregory Storch, None; Mae Gordon, None
  • Footnotes
    Support  NIH R34 Grant (EY023633-01A1), NIH Core Grant (P30EY002687), and unrestricted departmental grant from Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6257. doi:https://doi.org/
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      Andrew Hartwick, Tammy Than, Bojana Rodic-Polic, Spencer Johnson, Mary Migneco, Ellen Shorter, Jennifer S Harthan, Christina Morettin, Meredith Whiteside, Christian K. Olson, Mathew Margolis, Julia Huecker, Gregory Storch, Mae O Gordon; Reducing Adenoviral Patient-Infected Days (RAPID) Study: A Randomized Trial Assessing Efficacy of One Time, In-Office Application of 5% Povidone-Iodine in Treatment of Adenoviral Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6257. doi: https://doi.org/.

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

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Abstract

Purpose : To report results of a double-masked pilot clinical trial of 5% povidone-iodine (PVP-I) for treatment of adenoviral conjunctivitis (Ad-Cs).

Methods : Patients with presumed Ad-Cs were screened at 9 centers. Inclusion criteria were a positive AdenoPlusTM (Quidel, San Diego CA) immunoassay, age ≥ 18 and symptom onset ≤ 4 days. Of 212 patients screened, 56 were eligible and randomized to a single, in-office administration of either 5% PVP-I or artificial tears (AT). Follow-up visits were at days 1-2, 4, 7, 14 and 21. At each visit, a masked clinician graded clinical signs, administered a 10-symptom survey, and obtained a conjunctival swab sample. Samples were analyzed using an adenovirus-specific primer set and an Integrated qPCR Cycler (DiaSorin Molecular, Cypress CA).

Results : Of the 56 randomized participants who tested positive with the AdenoPlus at the eligibility visit, only 50% (28/56) were confirmed positive for Ad-Cs by qPCR. Of the 28 qPCR+ participants, 16 received 5% PVP-I and 12 received AT. Baseline viral titers were 14.8 ± 3.5 SD log DNA copies/ml in the PVP-I group and 14.6 ± 2.8 in the AT group (p=0.91, Wilcoxon). At day 4: 1) log titers were 8.9 ± 5.9 in the PVP-I group and 13.4 ± 2.6 in the AT group (p=0.08); 2) participant-reported tearing, eyelid swelling and redness significantly improved in the PVP-I group compared to the AT group (p<0.05), with eyelash matting (p=0.05) and overall discomfort (p=0.07) showing similar trends ; 3) clinician-graded mucoid discharge, bulbar redness, bulbar edema and follicular response were significantly lower in the PVP-I group compared to the AT group (p<0.05). There were no significant differences between the groups in viral titers, symptoms or signs at days 1-2, 7, 14 nor 21. In qPCR- participants, there was no benefit from 5% PVP-I on the outcome measures at any visit with the exception of clinician-graded eyelid matting on days 1-2.

Conclusions : Among participants testing positive for Ad-Cs by qPCR, those receiving a one time, in-office application of 5% PVP-I showed improvement in signs and symptoms and lower viral titers at day 4 compared to participants who received AT. There was no benefit of 5% PVP-I in participants who tested negative for Ad-Cs by qPCR at the same time-point.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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