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:: Volume 28, Issue 3 (Scientific Journal of Kurdistan University of Medical Sciences 2023) ::
SJKU 2023, 28(3): 68-77 Back to browse issues page
Effect of Povidone-Iodine in the Treatment of Epidemic Keratoconjunctivitis: A Clinical Trail Study
Mohammad hosein Validad Validad1 , Gholamreza Seyedpiran2 , Mahjoob3
1- Department of Ophthalmology, Alzahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
2- Alzahra Eye Hospital, Department of Ophthalmology, Zahedan University of Medical Sciences, Zahedan, Iran
3- Assistant Professor, Health Promotion Research Center/Department of Optometry, Rehabilitation Faculty, Zahedan University of Medical Sciences, Zahedan, Iran , mahjoob_opt@yahoo.com
Abstract:   (1422 Views)
Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of povidone-iodine 0.4% and 0.2% in the improvement of the symptoms and signs of patients with epidemic keratoconjunctivitis.
Materials and Methods: This clinical trial study included 60 patients with a mean age of 27.8±8.4 years who met our inclusion criteria.The patients were randomly divided into three groups. The first group received povidone-iodine 0.4% and betamethasone 0.1% eye drops the second group received povidone-iodine 0.2% and betamethasone 0.1% eye drops and the third group received betamethasone 0.1% eye drop.  Follow-ups visits were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration.
Results: The results showed significant differences in the mucopurulent discharge among the treatment groups on the fourth day (P = 0.005) and also on the seventh day (P = 0.001) of the examination. There was no significant difference among the 3 groups in regard to sub-epithelial infiltration on the tenth day after treatment (P = 0.287).
Conclusion: Based on the results of this study, povidone-iodine was more effective than steroids alone in relieving some of the signs of EKC, such as mucopurulent discharge.

 
Keywords: Keratoconjunctivitis, Povidone-Iodine, Betamethasone, Clinical trial, Adenovirus
Full-Text [PDF 780 kb]   (575 Downloads)    
Type of Study: Original Research | Subject: Medicine - Ophthalmology
Received: 2022/01/6 | Accepted: 2022/08/16 | Published: 2023/07/31
References
1. Pihos AM. Epidemic keratoconjunctivitis: a review of current concepts in management. J Optom. 2013 Apr; 6(2):69-74. Available from: [DOI:10.1016/j.optom.2012.08.003] []
3. Russell W. Adenoviruses: update on structure and function. J Gen Virol. 2009 Jan; 90(1):1-20. Available from: [DOI:10.1099/vir.0.003087-0] [PMID]
4. Akkaya S, Ozkurt YB. Persistent Symblepharon in an infant following epidemic keratoconjunctivitis. Med Hypothesis Discov Innov Ophthalmol. 2016; 5(3):74.
5. Özen Tunay Z, Ozdemir O, Petricli IS. Povidone iodine in the treatment of adenoviral conjunctivitis in infants. Cutan Ocul Toxicol. 2015 Jan 2; 34(1):12-5. Available from: [DOI:10.3109/15569527.2014.888077] [PMID]
6. Butt AL, Chodosh J. Adenoviral keratoconjunctivitis in a tertiary care eye clinic. Cornea. 2006 Feb 1; 25(2):199-202. Available from [DOI:10.1097/01.ico.0000170693.13326.fb] [PMID]
7. Kaufman HE. Adenovirus advances: new diagnostic and therapeutic options. Curr Opin Ophthalmol. 2011 Jul 1; 22(4):290-3. Available from [DOI:10.1097/ICU.0b013e3283477cb5] [PMID]
8. Kovalyuk N, Kaiserman I, Mimouni M, Cohen O, Levartovsky S, Sherbany H, et al. Treatment of adenoviral keratoconjunctivitis with a combination of povidone‐iodine 1.0% and dexamethasone 0.1% drops: a clinical prospective controlled randomized study. Acta Ophthalmol. 2017 Dec; 95(8):e686-e92. Available from: [DOI:10.1111/aos.13416] [PMID]
9. Meyer-Rüsenberg B, Loderstädt U, Richard G, Kaulfers PM, Gesser C. Epidemic keratoconjunctivitis: the current situation and recommendations for prevention and treatment. Dtsch Arztebl Int. 2011 Jan; 108(27):475. Available from: [DOI:10.3238/arztebl.2011.0475] [PMID] []
10. Kulkarni C, Ballal K. A treatment protocol for minimizing duration and complications of adenoviral epidemic keratoconjunctivitis. Taiwan J Ophthalmol. 2020 Oct; 10(4):269. Available from: [DOI:10.4103/tjo.tjo_66_19] [PMID] []
11. Ward JB, Siojo LG, Waller SG. A prospective, masked clinical trial of trifluridine, dexamethasone, and artificial tears in the treatment of epidemic keratoconjunctivitis. Cornea. 1993 May 1; 12(3):216-21. Available from: [DOI:10.1097/00003226-199305000-00006] [PMID]
12. Reibaldi M, Avitabile T, Bandello F, Longo A, Bonfiglio V, Russo A, et al. The effectiveness of 0.6% povidone iodine eye drops in reducing the conjunctival bacterial load and needle contamination in patients undergoing anti-VEGF intravitreal injection: a prospective, randomized study. J Clin Med. 2019 Jul 13; 8(7):1031. Available from: [DOI:10.3390/jcm8071031] [PMID] []
13. Pinna A, Donadu MG, Usai D, Dore S, D'Amico‐Ricci G, Boscia F, et al. In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM®). Acta Ophthalmol. 2020 Mar; 98(2):e178-e80. Available from: [DOI:10.1111/aos.14243] [PMID]
14. Pelletier J, Stewart K, Trattler W, Ritterband D, Braverman S, Samson C, et al. A combination povidone-iodine 0.4%/dexamethasone 0.1% ophthalmic suspension in the treatment of adenoviral conjunctivitis. Adv Ther. 2009 Aug; 26(8):776-83. Available from: [DOI:10.1007/s12325-009-0062-1] [PMID]
15. Trinavarat A, Atchaneeyasakul L. Treatment of epidemic Keratoconjunctivitis with 2% povidone-iodine: a pilot study. J Ocul Pharmacol Ther. 2012 Feb 1;28(1):53-8. Available from: [DOI:10.1089/jop.2011.0082] [PMID]
16. Lachapelle J-M, Castel O, Casado AF, Leroy B, Micali G, Tennstedt D, et al. Antiseptics in the era of bacterial resistance: a focus on povidone iodine. Clinical Practice. 2013 Sep 1; 10(5):579. [DOI:10.2217/cpr.13.50]
17. Oliverio GW, Spinella R, Postorino EI, Inferrera L, Aragona E, Aragona P. Safety and Tolerability of an Eye Drop Based on 0.6% Povidone-Iodine Nanoemulsion in Dry Eye Patients. J Ocul Pharmacol Ther. 2021 Mar 1; 37(2):90-6. Available from: [DOI:10.1089/jop.2020.0085] [PMID] []
18. Chou SF, Lin CH, Chang SW. Povidone-iodine application induces corneal cell death through fixation. Br J Ophthalmol. 2011 Feb 1; 95(2): 277-83. Available from: http://dx.doi.org/10.1136/bjo.2010.189407 [DOI:10.1136/bjo.2010.189407] [PMID]
19. Pihos AM. Epidemic keratoconjunctivitis: a review of current concepts in management. J Optom. 2013 Apr; 6(2):69-74. Available from: https://doi.org/10.1016/j.optom.2012.08.003 [DOI:10.1016/j.optom.2012.08.003.] []
20. Russell W. Adenoviruses: update on structure and function. J Gen Virol. 2009 Jan; 90(1):1-20. Available from: [DOI:10.1099/vir.0.003087-0] [PMID]
21. Akkaya S, Ozkurt YB. Persistent Symblepharon in an infant following epidemic keratoconjunctivitis. Med Hypothesis Discov Innov Ophthalmol. 2016; 5(3):74.
22. Özen Tunay Z, Ozdemir O, Petricli IS. Povidone iodine in the treatment of adenoviral conjunctivitis in infants. Cutan Ocul Toxicol. 2015 Jan 2; 34(1):12-5. Available from: [DOI:10.3109/15569527.2014.888077] [PMID]
23. Butt AL, Chodosh J. Adenoviral keratoconjunctivitis in a tertiary care eye clinic. Cornea. 2006 Feb 1; 25(2):199-202. Available from [DOI:10.1097/01.ico.0000170693.13326.fb] [PMID]
24. Kaufman HE. Adenovirus advances: new diagnostic and therapeutic options. Curr Opin Ophthalmol. 2011 Jul 1; 22(4):290-3. Available from [DOI:10.1097/ICU.0b013e3283477cb5] [PMID]
25. Kovalyuk N, Kaiserman I, Mimouni M, Cohen O, Levartovsky S, Sherbany H, et al. Treatment of adenoviral keratoconjunctivitis with a combination of povidone‐iodine 1.0% and dexamethasone 0.1% drops: a clinical prospective controlled randomized study. Acta Ophthalmol. 2017 Dec; 95(8):e686-e92. Available from: [DOI:10.1111/aos.13416] [PMID]
26. Meyer-Rüsenberg B, Loderstädt U, Richard G, Kaulfers PM, Gesser C. Epidemic keratoconjunctivitis: the current situation and recommendations for prevention and treatment. Dtsch Arztebl Int. 2011 Jan; 108(27):475. Available from: [DOI:10.3238/arztebl.2011.0475] [PMID] []
27. Kulkarni C, Ballal K. A treatment protocol for minimizing duration and complications of adenoviral epidemic keratoconjunctivitis. Taiwan J Ophthalmol. 2020 Oct; 10(4):269. Available from: [DOI:10.4103/tjo.tjo_66_19] [PMID] []
28. Ward JB, Siojo LG, Waller SG. A prospective, masked clinical trial of trifluridine, dexamethasone, and artificial tears in the treatment of epidemic keratoconjunctivitis. Cornea. 1993 May 1; 12(3):216-21. Available from: [DOI:10.1097/00003226-199305000-00006] [PMID]
29. Reibaldi M, Avitabile T, Bandello F, Longo A, Bonfiglio V, Russo A, et al. The effectiveness of 0.6% povidone iodine eye drops in reducing the conjunctival bacterial load and needle contamination in patients undergoing anti-VEGF intravitreal injection: a prospective, randomized study. J Clin Med. 2019 Jul 13; 8(7):1031. Available from: [DOI:10.3390/jcm8071031] [PMID] []
30. Pinna A, Donadu MG, Usai D, Dore S, D'Amico‐Ricci G, Boscia F, et al. In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM®). Acta Ophthalmol. 2020 Mar; 98(2):e178-e80. Available from: [DOI:10.1111/aos.14243] [PMID]
31. Pelletier J, Stewart K, Trattler W, Ritterband D, Braverman S, Samson C, et al. A combination povidone-iodine 0.4%/dexamethasone 0.1% ophthalmic suspension in the treatment of adenoviral conjunctivitis. Adv Ther. 2009 Aug; 26(8):776-83. Available from: [DOI:10.1007/s12325-009-0062-1] [PMID]
32. Trinavarat A, Atchaneeyasakul L. Treatment of epidemic Keratoconjunctivitis with 2% povidone-iodine: a pilot study. J Ocul Pharmacol Ther. 2012 Feb 1;28(1):53-8. Available from: [DOI:10.1089/jop.2011.0082] [PMID]
33. Lachapelle J-M, Castel O, Casado AF, Leroy B, Micali G, Tennstedt D, et al. Antiseptics in the era of bacterial resistance: a focus on povidone iodine. Clinical Practice. 2013 Sep 1; 10(5):579. [DOI:10.2217/cpr.13.50]
34. Oliverio GW, Spinella R, Postorino EI, Inferrera L, Aragona E, Aragona P. Safety and Tolerability of an Eye Drop Based on 0.6% Povidone-Iodine Nanoemulsion in Dry Eye Patients. J Ocul Pharmacol Ther. 2021 Mar 1; 37(2):90-6. Available from: [DOI:10.1089/jop.2020.0085] [PMID] []
35. Chou SF, Lin CH, Chang SW. Povidone-iodine application induces corneal cell death through fixation. Br J Ophthalmol. 2011 Feb 1; 95(2): 277-83. Available from: http://dx.doi.org/10.1136/bjo.2010.189407 [DOI:10.1136/bjo.2010.189407] [PMID]
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Ethics code: IR.ZAUMS.REC.1497
Clinical trials code: IRCT2015021518004N2

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Validad M H V, Seyedpiran G, Mahjoob. Effect of Povidone-Iodine in the Treatment of Epidemic Keratoconjunctivitis: A Clinical Trail Study. SJKU 2023; 28 (3) :68-77
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Volume 28, Issue 3 (Scientific Journal of Kurdistan University of Medical Sciences 2023) Back to browse issues page
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
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