povidone-iodine and Eye-Infections--Viral

This investigation reports the correlation of conjunctival viral titers in adenoviral conjunctivitis with patient-reported symptoms and clinician-graded signs for 21 days of follow-up.. Adenoviral conjunctivitis is a highly contagious viral eye infection with significant morbidity and economic impact. This study investigates whether severity of signs and symptoms and time to viral clearance are correlated with conjunctival viral titers at baseline and during 21 days of follow-up.. The Reducing Adenoviral Patient Infected Days study was a pilot study of the efficacy of a single in-office administration of ophthalmic 5% povidone-iodine. This article outlines longitudinal analyses after the primary outcome report. Of 212 participants screened, 28 participants with quantitative polymerase chain reaction-confirmed adenoviral conjunctivitis were randomized and had follow-up visits on days 1, 2, 4, 7, 14, and 21. At each visit, clinician-graded signs, participant-reported symptoms, and a conjunctival swab for quantitative polymerase chain reaction analysis were obtained. The correlation of viral titers with symptoms and signs was calculated: (1) cross-sectionally at each visit and (2) longitudinally for 21 days using a repeated-measures mixed-effects model.. Twenty-five of 28 participants had sufficient data for this report. Higher viral titers for 21 days were correlated with greater severity of symptoms (tearing, matting, and redness, r ≥ 0.70; P < .02) and greater severity of clinical signs (bulbar redness and serous discharge, r ≥ 0.60; P < .01). Eyes with highest baseline viral titers required longer time to viral clearance ( r = 0.59, P = .008). Signs and symptoms persisted in approximately half of the eyes even after viral clearance.. Higher conjunctival viral titers across 21 days were strongly correlated with more severe signs and symptoms and longer time to viral clearance. Our results also indicate that symptoms and signs can persist after viral clearance.

Topics: Conjunctiva; Conjunctivitis; Double-Blind Method; Eye Infections, Viral; Humans; Ophthalmic Solutions; Pilot Projects; Povidone-Iodine

The effectiveness of masking is rarely evaluated or reported in single- or double-masked clinical trials. Knowledge of treatment assignment by participants and clinicians can bias the assessment of treatment efficacy.. This study aimed to evaluate the effectiveness of masking in a double-masked trial of 5% povidone-iodine for the treatment of adenoviral conjunctivitis.. The Reducing Adenoviral Patient Infected Days study is a double-masked, randomized trial comparing a one-time, in-office administration of 5% povidone-iodine with artificial tears for the treatment of adenoviral conjunctivitis. Masking was assessed by asking participants and masked clinicians at designated time points if they believed the treatment administered was povidone-iodine or artificial tears, or if they were unsure. Adequacy of masking was quantified using a modified Bang Blinding Index.. Immediately after treatment, 34% of participants who received povidone-iodine and 69% of those who received artificial tears guessed incorrectly or were unsure of their treatment (modified Bang Indices of 0.31 and -0.38, respectively). On day 4, 38% of the povidone-iodine participants and 52% of the artificial tear participants guessed incorrectly or were unsure of their treatment (modified Bang Indices of 0.24 and -0.05, respectively), indicating adequate and ideal masking. On days 1, 4, 7, 14, and 21, masked clinicians guessed incorrectly or were unsure of treatment in 53%, 50%, 40%, 39%, and 42% among povidone-iodine participants compared with 44%, 35%, 38%, 35%, and 39% among artificial tears participants, respectively. The modified Bang Indices for clinician masking in the povidone-iodine group ranged from -0.05 to 0.25 and from 0.13 to 0.29 in the artificial tears group.. Masking of participants and clinicians was adequate. Successful masking increases confidence that subjective measurements are not biased. We recommend quantitative assessment and reporting the effectiveness of masking in ophthalmic clinical trials.

Topics: Adenovirus Infections, Human; Administration, Ophthalmic; Adolescent; Adult; Anti-Infective Agents, Local; Conjunctivitis, Viral; Double-Blind Method; Eye Infections, Viral; Female; Humans; Lubricant Eye Drops; Male; Ophthalmic Solutions; Pilot Projects; Povidone-Iodine; Treatment Outcome; Young Adult

To report safety and tolerability of a one-time administration of ophthalmic 5% povidone-iodine (5% PVP-I) in a double-masked randomized trial for the treatment of adenoviral conjunctivitis (Ad-Cs).. Of 212 participants screened, 56 eligible participants with red eye symptoms ≤4 days and a positive adenoviral rapid immunoassay were randomized to a one-time administration of ophthalmic 5% PVP-I or preservative free artificial tears (AT). Safety was assessed by corneal fluorescein staining (baseline, immediate post-administration and Day 1) and visual acuity (VA) (baseline and Day 1). Tolerability was assessed using participant-rated overall ocular discomfort (baseline, immediately post-administration and on Day 1.. In the 5% PVP-I group, corneal staining increased immediately post-administration but returned to baseline levels by Day 1. There was no change in VA between baseline and Day 1 in either 5% PVP-I or AT groups (p = 0.87). In the 5% PVP-I group, there was no change in participant-rated overall discomfort immediately post-administration (p = 0.78) or on day 1 (p = 0.10) compared to baseline. In the AT group, participant-rated overall discomfort was lower immediately post-administration but returned to baseline levels by Day 1. One adverse event was reported in the 5% PVP-I group on Day 1-2 that was classified as not related to treatment.. These results suggest ophthalmic 5% PVP-I used as a one-time treatment is safe and well tolerated by patients with Ad-Cs.

Topics: Adenoviridae Infections; Adult; Conjunctivitis; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Eye Infections, Viral; Female; Follow-Up Studies; Humans; Lubricant Eye Drops; Male; Povidone-Iodine; Retrospective Studies; Treatment Outcome; Visual Acuity

To determine the efficacy of combination povidone-iodine (PVP-I) 1.0% eyedrops and dexamethasone 0.1% eyedrops in the treatment of adenoviral keratoconjunctivitis.. In a prospective, randomized, controlled, double-blinded clinical trial patients with recent adenoviral keratoconjunctivitis (diagnosed clinically and confirmed by PCR), we randomly divided into three treatment groups: study group - received PVP-I 1.0% and dexamethasone 0.1%, control 1 group - received dexamethasone 0.1% and control 2 group - received lubricating eyedrops (hypromellose 0.3%). The treatment was administered four times a day in each group. All patients were examined and filled a questionnaire before treatment and on the 3rd, 5th and 7th days of treatment.. We included in the study 78 eyes (26 in each group). Adenovirus type 8 was the most common pathogen (83% of cases). The fastest improvement in patients red eyes, discharge, superficial punctate keratitis and pseudomembranes was observed in the study group (p < 0.001). Those patients reached a near complete recovery in 5-7 days, which was also confirmed by reduction in Adenovirus titres by PCR. The slowest improvement was in the control 2 group. Subepithelial infiltrates (SEI) were observed in 44% of the control 1 group, 20% of the control 2 group and in 0% of the study group. The rate of reduction in Adenovirus titres was the slowest in the control 1 group.. The combination of PVP-I 1.0% and dexamethasone 0.1% four times a day can reduce symptoms and expedite recovery in epidemic keratoconjunctivitis patients.

Topics: Acute Disease; Adenoviridae; Adenoviridae Infections; Adult; Anti-Infective Agents, Local; Dexamethasone; DNA, Viral; Dose-Response Relationship, Drug; Double-Blind Method; Drug Therapy, Combination; Eye Infections, Viral; Female; Follow-Up Studies; Glucocorticoids; Humans; Keratoconjunctivitis; Male; Middle Aged; Ophthalmic Solutions; Povidone-Iodine; Prospective Studies; Reverse Transcriptase Polymerase Chain Reaction; Treatment Outcome

150 patients with adenovirus type 8 infection where treated at random, in a prospective study. Based upon a quantifiable conjunctivitis severity score we tried to find out where there are differences in treatment. The best results were seen using polyvinylpyrrolidone-iodine (Betaisodona) although it could not prevent totally subepithelial corneal infiltrates. The combination of exogenous interferon alpha with polyvinylpyrrolidone-iodo-drops or trifluorothymidine-drops was less successful. We could not show any prophylactic effect of interferon on uninflamed fellow eyes. Treatment with vasoconstrictor did not show any therapeutic or prophylactic potency. This group of patients must be seen as a control group and the results of effective therapy should significantly differ from the results in this group. Topical corticosteroids should be reserved for severe symptomatic cases and those with iritis and pseudomembranous conjunctivitis. Giving topical corticosteroids in combination with antibiotics we did not find any influence on the incidence of subepithelial keratitis or the number of corneal infiltrates. The mean duration of acute keratoconjunctivitis using this therapy was longer than the mean duration in the control group with vasoconstrictor.

Topics: Acrylic Resins; Adenovirus Infections, Human; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dexamethasone; Disease Outbreaks; Drug Therapy, Combination; Eye Infections, Viral; Gentamicins; Humans; Interferons; Keratoconjunctivitis; Middle Aged; Ophthalmic Solutions; Oxymetazoline; Povidone-Iodine; Prospective Studies; Trifluridine

Topics: Adenovirus Infections, Human; Administration, Ophthalmic; Adolescent; Anti-Infective Agents, Local; Antiviral Agents; Child; Drug Synergism; Eye Infections, Viral; Female; Ganciclovir; Humans; Immunoassay; Keratoconjunctivitis; Male; Ophthalmic Solutions; Povidone-Iodine; Retrospective Studies

Topics: Administration, Ophthalmic; Anti-Infective Agents, Local; Betacoronavirus; Coronavirus Infections; COVID-19; Disease Transmission, Infectious; Eye Infections, Viral; Humans; Ophthalmic Solutions; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

Topics: Anti-Infective Agents, Local; Benzalkonium Compounds; Betacoronavirus; Coronavirus Infections; COVID-19; Cross Infection; Disease Transmission, Infectious; Eye Infections, Viral; Hand Disinfection; Humans; Infection Control; Masks; Pandemics; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2

Povidone-iodine (P-I) is being touted as a topical antiviral treatment for eye infections caused by adenovirus (Ad). This study evaluated the in vitro antiviral activity of the several P-I concentrations previously used in clinical studies against multiple ocular Ad types commonly associated with eye infections.. The antiviral activity of four concentrations of P-I was compared to vehicle for seven types of Ad after incubating the P-I with Ad at 33°C for various lengths of time. Following incubation and neutralization of the P-I with sodium thiosulfate, viral titers were determined for each Ad type and time point.

Topics: A549 Cells; Adenoviridae; Adenoviridae Infections; Antiviral Agents; Dose-Response Relationship, Drug; Eye Infections, Viral; Humans; Microbial Sensitivity Tests; Povidone-Iodine; Structure-Activity Relationship

Topics: Africa; Anti-Infective Agents, Local; Developing Countries; Drug Administration Schedule; Eye Infections, Viral; Humans; Infant, Newborn; Ophthalmia Neonatorum; Ophthalmic Solutions; Povidone-Iodine

Topics: Eye Infections, Viral; Humans; Keratoconjunctivitis; Ophthalmic Solutions; Povidone-Iodine