Evaluation of the impact of persistent subepithelial corneal infiltrations on the visual performance and corneal optical quality after epidemic keratoconjunctivitis

Abstract

ABSTRACT.Purpose: Aim was to measure the effect of persistent subepithelial corneal infiltrates (SEIs) after epidemic keratoconjunctivitis (EKC) on visual performance and corneal optical quality. Methods: We examined 53 patients divided into two groups. Patients with previous EKC constituted the study group (Group 1, n: 27). Healthy age matched subjects constituted the control group (Group 2, n: 26). Study group was subdivided into eyes with SEI (Group 1A, 40 eyes) and healthy fellow eyes (Group 1B, 14 eyes). Patients were submitted to a complete examination including high-and low-contrast visual acuities (HCVA, LCVA), corneal topography and aberrometry. Results: The mean interval between epidemic conjunctivitis and examination was 7.25 AE 5.63 months. Mean number of corneal infiltrates was 17.30 AE 14.38. The mean HCVA and LCVA were significantly lower in the eyes with SEI than fellow eyes and control group (p = 0.001). LCVA value was also worse in the fellow eyes when compared to control (p = 0.048). Corneal topography values were significantly higher in the eyes with SEI from both fellow eyes and control group. During corneal aberrometry, the mean root mean square value of spheric aberration, irregular astigmatism and total aberration were significantly higher in SEI group when compared to fellow eyes and control group (p < 0.05). Total aberrations were higher than control subjects in the fellow eyes. Trefoil aberration was higher in SEI group only when compared to control subjects, while there was no significant difference in coma aberration values between the groups (p > 0.05). Conclusion: Results of this study suggested that visual performance is compromised in patients with EKC by aberrations and changes in topographic variables.Key words: corneal aberrometry -corneal topography -epidemic keratoconjunctivitislow-contrast visual acuity -subepithelial corneal infiltrations None of the authors has conflict of interest with the submission.

Pathogenesis and management of adenoviral keratoconjunctivitis

“…Accumulation of lymphocytes, macrophages/monocytes, and activated fibroblasts in response to AdV-infected corneal keratocytes is a hallmark histopathological feature of subepithelial (stromal) corneal infiltrates. 110 – 113 These opacities may persist for up to several weeks to years and have the tendency to result in visual decrease, glare, photophobia, and irregular astigmatism. 3 , 110 Kaye et al 114 used primers for AdV hexon genes to amplify extracted adenoviral DNA from ocular samples of patients who had a history of AdV.…”

“… 110 – 113 These opacities may persist for up to several weeks to years and have the tendency to result in visual decrease, glare, photophobia, and irregular astigmatism. 3 , 110 Kaye et al 114 used primers for AdV hexon genes to amplify extracted adenoviral DNA from ocular samples of patients who had a history of AdV. These researchers were able to demonstrate the presence of amplifiable adenoviral DNA in ocular samples, such as tears, indicating that the presence of adenoviral DNA was associated with chronic papillary conjunctivitis.…”

The effect of corneal infiltrates on densitometry and higher‐order aberrations

“…This study evaluated only corneal aberrations, not total ocular aberrations, since the cornea, which is the first refractive interface, is the most important contributor to the total refractive power of the eye. Kurna et al also measured the effect of persistent corneal subepithelial infiltrates on visual performance and corneal optical quality by using a corneal aberrometry and found that spherical aberration, irregular astigmatism, and total aberration values were significantly higher in eyes with subepithelial infiltrates than in the fellow healthy eyes and control eyes.…”

Occurrence of viral DNA in paired samples of corneal rim and cornea preservation fluid

“…Persisting sublaminal foci were also observed during chronic infections with HAdV. In these cases, intermittent periods of symptomatic infections are observed, when the risk of virus shedding is higher by definition, thus it is potentially possible to find HAdV DNA in cornea sample of patient with chronic infection, even during asymptomatic phase [Aydin Kurna et al, ]. It is also possible to find HAdV DNA in tear film years after episode of acute conjunctivitis, what may be either an effect of chronic asymptomatic HAdV infection or superinfection with another type of adenovirus, what obviously should be confirmed by HAdV typing [Kaye et al, ].…”