Research Information System
Ocular Immunology and Inflammation, vol.33, no.8, pp.1748-1756, 2025 (SCI-Expanded)
Purpose: To evaluate the efficacy of topical ganciclovir (GCV), povidone-iodine (PVP-I), and their combination with loteprednol etabonate (LE) in reducing viral load and improving clinical outcomes in adenoviral conjunctivitis. Methods: This single-centered, controlled study enrolled patients diagnosed with adenoviral conjunctivitis, confirmed by the Rapid Pathogen Screening Adeno-Detector Plus test. Participants were assigned to five treatment groups: artificial tears (AT) as the control group, and the treatment groups included PVP-I, GCV, PVP-I/LE, and GCV/LE. Treatment efficacy was assessed by viral load, clinical sign and symptom scores, and complications (subepithelial infiltrates and pseudomembranes). The early phase encompassed days 0–7, and the late phase covered days 8–14. Results: Seventy-five eyes were included. Adenovirus type 8 was the most common pathogen (95%). At baseline, clinical signs and symptoms were similar among groups (p > 0.05), but viral loads differed significantly (p = 0.036). The greatest reduction in viral load in the early phase was observed in the PVP-I group (p < 0.05). The fastest improvement of the clinical signs and symptoms was observed in the PVP-I/LE and the GCV/LE group (p < 0.05). Subepithelial infiltrates were significantly less frequent in the PVP-I/LE group (p = 0.014). Conclusions: The combination of PVP-I/LE effectively reduced viral load and improved clinical outcomes in adenoviral conjunctivitis. PVP-I significantly decreased viral load in the early phase, while PVP-I/LE and GCV/LE combinations led to faster clinical improvement. Subepithelial infiltrates were significantly lower in the PVP-I/LE group, suggesting this combination may help prevent complications and offer an effective treatment option.