Update on Antiviral Treatment of Adenoviral Ocular Infections

Abstract

Since the initial description of epidemic adenoviral ocular infections in Austria in 1889 1 Murrah W.F. Epidemic keratoconjunctivitis. Ann Ophthalmol. 1988; 20: 36-38 PubMed Google Scholar until the present day, no effective drug to treat such patients has been found. Today, acute adenoviral ocular infections (epidemic keratoconjunctivitis, follicular conjunctivitis, and pharyngeal conjunctival fever) remain among the most common external ocular viral infections seen clinically worldwide, with more than one million cases annually in Japan. 2 Uchio E. Fuchigami A. Kadonosono K. et al. Anti-adenoviral effect of anti-HIV agents in vitro in serotypes inducing keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol. 2007; 245: 1319-1325 Crossref PubMed Scopus (15) Google Scholar There are 51 serotypes of adenovirus, of which approximately one-half have been shown to cause ocular disease. 3 Gordon J.S. Aoki K. Kinchington P.R. Adenovirus keratoconjunctivitis. in: Pepose J.S. Holland G.N. Wilhelmus K.R. Ocular Infection & Immunity. Mosby, St Louis, Missouri1996: 877-894 Google Scholar The American Academy of Ophthalmology Preferred Practice Pattern proposes symptomatic treatment for these infections and the use of topical steroids to reduce scarring in severe cases of adenoviral keratoconjunctivitis with marked chemosis or lid swelling, epithelial sloughing, or membranous conjunctivitis. 4 American Academy of OphthalmologyPreferred Practice Pattern, Adenoviral Conjunctivitis. http://one.aao.org/CE/PracticeGuidelines/PPP Google Scholar Lacking an effective Food and Drug Administration-approved antiviral, clinicians recognize the continuing need to develop a drug to reduce patient morbidity, to reduce the extent of or entirely prevent the formation of vision-altering subepithelial infiltrates, to reduce lost time from school or work, and to reduce or prevent the transmission of ocular infections within households, communities, and medical facilities.