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2016 Agenda and Abstracts | < Previous | Next > 2016 OMIG Abstract 23 Association of Clinical Outcomes with Molecular Adenoviral Species in Acute Keratoconjunctivitis Purpose: To define various species and types found in adenoviral acute/epidemic keratoconjunctivitis (KC) and correlate to clinical presentations and outcomes. Methods: 500 patients from United States, India, Brazil, and Sri Lanka with clinical diagnosis of KC and positive rapid testing for adenovirus (AdV) were included in the study. Clinical signs and symptoms and bilateral conjunctival swabs were obtained on day 1, 3, 6, 11, and 18. PCR was performed to detect and quantify AdV in all conjunctival samples. The difference in composite scores of clinical signs and symptoms between day 1 and day 18 were evaluated by AdV species using ANOVA. Time to resolution of each symptom or sign were assessed by AdV species with Cox regression. Results: Of 500 patients, 390 (78%) had evidence of AdV infection by PCR. Among AdV positive patients, 4 species and 21 types of AdV were detected with AdV D being the most prevalent species (84%; 11 types). The mean difference in composite scores of signs (p=0.003) and symptoms (p=0.009) between day 1 and 18 was significantly different by AdV species. The hazard for resolution of lid edema (HR 0.41, p<0.001, adj.p=0.009), bulbar conjunctival injection (HR 0.55, p<0.001, adj.p=0.009), abnormal tear meniscus (HR 0.56, p=0.007, adj.p=0.06), tearing (HR 0.54, p<0.001, adj p<0.06), and photophobia (HR 0.54, p=0.008, adj.p=0.05) were significantly lower in AdV-D group compared to non-D group. Conclusion: AdV-D infection related signs and symptoms are significantly more severe and less likely to resolve. Identifying patients infected AdV-D at early stage may have clinical implications in providing appropriate therapy and prognosis. CL(N), AL(N), LA(N), KN(E), DS(E), AW(N), RVG(N) 2016
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