Patients with adenoviral conjunctivitis who received a one time, in-office application of 5% povidone-iodine (PVP-I) showed improvement in signs and symptoms, lower viral titers and lower IL-8 levels after four days, compared with participants who received artificial tears. Tammy Than, OD, a staff optometrist at the Carl Vinson VA Medical Center in Dublin, Georgia, presented the pilot findings of the Reducing Adenoviral Patient-Infected Days (RAPID) study, a double-masked randomized pilot trial of 5% Betadine (povidone-iodine, Avrio Health) for the treatment of adenoviral conjunctivitis.

In 28 patients with adenoviral conjunctivitis, the researchers administered Betadine to 16 and artificial tears to 12. Follow-up visits were at days one, two, four, seven, 14 and 21. At each follow-up visit, a masked clinician graded clinical signs, administered a symptom survey and obtained a conjunctival swab sample for qPCR and IL-8 assays.

At day four, adenoviral titers had decreased to 2.5% in the Betadine group, relative to peak titer levels (100%) measured at one of the first two visits, while titers decreased to 14.4% in the artificial tears group. Participant-reported eyelid swelling, tearing and redness, eyelash matting and overall discomfort were significantly lower in the Betadine group. Clinician-graded mucoid discharge, bulbar redness, bulbar edema and follicular response were significantly lower in the PVP-I group.

The researchers did note that there was no benefit of 5% Betadine on any outcome in participants who tested negative for adenoviral conjunctivitis by qPCR at the same time-point. 

Than TP, Hartwick AT, Migneco M, et al. Hot topics in anterior segment. Academy 2019 Orlando.