PCR-Based Evaluation of Viral Load Reduction in Adenoviral Conjunctivitis: A Comparative Study of Ganciclovir and Povidone-Iodine.

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.