Kovalyuk Natalya, Kaiserman Igor, Mimouni Michael, Cohen Ornit, Levartovsky Shmuel, Sherbany Hilda, Mandelboim Michal
Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.
Department of health science, Ben Gurion University, Be'er Sheva, Israel.
Acta Ophthalmol. 2017 Dec;95(8):e686-e692. doi: 10.1111/aos.13416. Epub 2017 Mar 25.
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.
确定1.0%聚维酮碘（PVP - I）滴眼液与0.1%地塞米松滴眼液联合应用治疗腺病毒性角结膜炎的疗效。
在一项前瞻性、随机、对照、双盲临床试验中，将近期患有腺病毒性角结膜炎（临床诊断并经PCR确诊）的患者随机分为三组：研究组——接受1.0% PVP - I和0.1%地塞米松治疗；对照组1——接受0.1%地塞米松治疗；对照组2——接受润滑滴眼液（0.3%羟丙甲纤维素）治疗。每组每天给药4次。所有患者在治疗前以及治疗第3、5和7天接受检查并填写问卷。
本研究纳入78只眼（每组26只）。8型腺病毒是最常见的病原体（83%的病例）。研究组患者的眼红、分泌物、浅层点状角膜炎和假膜症状改善最快（p < 0.001）。这些患者在5 - 7天内接近完全康复，PCR检测腺病毒滴度降低也证实了这一点。对照组2症状改善最慢。对照组1中44%出现上皮下浸润（SEI），对照组2中20%出现SEI，研究组中未出现SEI。对照组1腺病毒滴度下降速度最慢。
每天4次使用1.0% PVP - I与0.1%地塞米松联合应用可减轻流行性角结膜炎患者的症状并加速康复。
