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Topical treatment of acute adenoviral keratoconjunctivitis with Cidofovir 0.2% and 1% with and without Cyclosporin A 1% a controlled clinical pilot studyJ. Hillenkamp1, T. Reinhard1, R. S. Ross3, M. Roggendorf3, E. Godehardt2, E. DeClercq4
Aim: To evaluate the efficacy of Cidofovir 0.2% and 1% eye drops (Cid) with and without Cyclosporin A eye drops (CsA) in the treatment of acute adenoviral keratoconjunctivitis (AKC).
Methods: A total of 40 patients with acute AKC of recent onset was divided in a randomised fashion into 4 treatment groups: a) Cid 0.2% administered four times daily (qid), b) CsA 1% qid, c) Cid 0.2% qid and CsA 1% qid, d) NaCl qid (control). The diagnosis was confirmed by adenoviral polymerase chain reaction applicated to conjunctival swabs. Duration of treatment was 21 days. Severity of conjunctival injection, conjunctival chemosis, superficial punctate keratitis during the course of treatment and presence and severity of corneal subepithelial infiltrates were evaluated by a clinical score. Duration until subjective improvement of symptoms was recorded.
Results: There was no statistically significant difference between the four treatment groups concerning the clinically relevant parameters. Particularly, we did not find a difference in the frequency of corneal subepithelial infiltrates at the end of the treatment period.
Discussion: Cid 0.2% and/or CsA 1% did not accelerate the improvement of clinical symptoms of acute AKC compared to the natural course of the infection as evaluated by the pilot study including 40 patients. This may be due to the wide spectrum of the clinical course of the infection, a too low number of patients enrolled in this study or a too low concentration of Cidofovir. We have therefore begun to clinically investigate the effect of higher concentrated Cidofovir eye drops (1%), with and without CsA 1% in an additional group of 30 patients since November 1999. To date, ten patients have completed the study protocol.
Dept. of Ophthalmology1, Dept. of Biostatistics, Dept. of Cardiovascular Surgery2, Heinrich Heine University, Düsseldorf, Germany; Inst. of Virology, Essen University, Essen, Germany3; Rega Institute, Catholic University, Leuven, Belgium4