June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Improving accuracy of adenoviral conjunctivitis diagnosis
Author Affiliations & Notes
  • Ellen Shorter
    Ophthalmology and Vision Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Chamila Perera
    Washington University in Saint Louis, Missouri, United States
  • Mary Migneco
    Washington University in Saint Louis, Missouri, United States
  • Meredith Whiteside
    UC Berkeley School of Optometry, California, United States
  • Jennifer Harthan
    Illinois College of Optometry, Illinois, United States
  • Andrew Hartwick
    Ohio State University, Ohio, United States
  • Spencer Johnson
    Northeastern State University, Oklahoma, United States
  • Christina Morettin
    Illinois College of Optometry, Illinois, United States
  • Julia Huecker
    Washington University in Saint Louis, Missouri, United States
  • Tammy Than
    Carl Vinson VA Medical Center, Georgia, United States
  • Mae Gordon
    Washington University in Saint Louis, Missouri, United States
  • Footnotes
    Commercial Relationships   Ellen Shorter, Johnson and Johnson (F); Chamila Perera, None; Mary Migneco, None; Meredith Whiteside, None; Jennifer Harthan, Allergan (R), Contamac (R), Contamac (F), Essilor (R), Essilor (C), Kala (F), Metro (R), Metro (C), Metro (F), Shire (F), Synergeyes (R), Takeda (R), Tangible Science (F); Andrew Hartwick, None; Spencer Johnson, None; Christina Morettin, None; Julia Huecker, None; Tammy Than, None; Mae Gordon, DiaSorin (F)
  • Footnotes
    Support  National Eye Institute Center R34 Grant (EY023633-01A1), a National Eye Institute Center Core Grant (P30EY002687), R21 Grant (EY030524-01) and an unrestricted grant to the Department of Ophthalmology and Visual Sciences from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4900. doi:
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      Ellen Shorter, Chamila Perera, Mary Migneco, Meredith Whiteside, Jennifer Harthan, Andrew Hartwick, Spencer Johnson, Christina Morettin, Julia Huecker, Tammy Than, Mae Gordon; Improving accuracy of adenoviral conjunctivitis diagnosis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4900.

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

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Purpose : To improve diagnostic accuracy of adenoviral conjunctivitis (Ad-Cs) with a multivariate model using presenting signs and symptoms.

Methods : Patients with acute red eye(s) and presumed Ad-Cs were enrolled at 9 clinics for eligibility in the Reducing Adenoviral Patient Infected Days (RAPID) study. Inclusion criteria were ≥ 18 years old with symptoms ≤ 4 days. The initial visit included conjunctival swab sample for qPCR Ad-Cs analysis, AdenoPlus point-of-care immunoassay (POCT) (QuickVue Test by Quidel, San Diego, CA) and the following clinical signs and symptoms (Table 1).

Variables were first screened based on the random forest variable importance measures. Penalized logistic regression was used to select a subset of variables that differentiated between Ad-Cs positive and negative patients. “Area under the curve” (AUC) was used to compare the prediction performance of different models.

Results : Of 212 participants, 185 had conjunctival swab samples, POCT and screening examination, of which, 30 tested positive for Ad-Cs by qPCR and 155 tested negative. The POCT had positive and negative predictive values of 50% and 98.5%, respectively. AUC for differentiating between qPCR positive and negative patients was 0.84 for slit lamp and physical exam findings, 0.69 for exposure factors, 0.76 for systemic symptoms, 0.82 for patient-symptoms and 0.87 for POCT. When the POCT was added to slit lamp and physical exam findings, the AUC increased from 0.84 to 0.95.

Conclusions : Although clinical findings such as lid edema, serous discharge, redness, conjunctival follicles and presence of pre-auricular nodes can provide reasonable accuracy in the diagnosis of Ad-Cs, when available, POCT can further improve diagnostic accuracy.

This is a 2020 ARVO Annual Meeting abstract.



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