Epidemic keratoconjunctivitis

TY - JOUR

T1 - Epidemic keratoconjunctivitis

T2 - the current situation and recommendations for prevention and treatment

AU - Stemplewitz, Birthe

AU - Loderstädt, Ulrike

AU - Richard, Gisbert

AU - Kaulfers, Paul-Michael

AU - Gesser, Caroline

AU - Stemplewitz, Birthe

PY - 2011/7/1

Y1 - 2011/7/1

N2 - BACKGROUND: Epidemic keratoconjunctivitis (EKC) is a highly contagious infection of the ocular surface. 316 cases were diagnosed in Germany in the first 8 months of 2010, corresponding to a 300% increase above the typical figures for recent years. This outbreak motivates us to present the current recommendations concerning EKC.METHODS: Selective literature review.RESULTS: EKC is an adenoviral infection that typically starts with a unilateral foreign body sensation and then develops, within a few hours or days, into bilateral keratoconjunctivitis with marked chemosis, epiphora, and photophobia. Visual impairment can persist for months because of subepithelial corneal infiltrates (nummuli) and irregular astigmatism. Randomized clinical trials have not shown any clear benefit in the acute phase from any of a variety of treatments, including steroids, calcineurin inhibitors, virostatic drugs and disinfecting agents. In the chronic phase, cyclosporin A eye drops can accelerate the regression of subepithelial infiltrates. Hygienic measures, including conscientious hand and surface disinfection, can lessen the spread of the disease.CONCLUSION: The first priority in the treatment of patients with definite or suspected EKC is the rigorous application of hygienic measures in medical facilities, particularly because there is still no effective drug treatment for this disease. No virostatic agent has yet been demonstrated to influence its course, either subjectively or objectively.

AB - BACKGROUND: Epidemic keratoconjunctivitis (EKC) is a highly contagious infection of the ocular surface. 316 cases were diagnosed in Germany in the first 8 months of 2010, corresponding to a 300% increase above the typical figures for recent years. This outbreak motivates us to present the current recommendations concerning EKC.METHODS: Selective literature review.RESULTS: EKC is an adenoviral infection that typically starts with a unilateral foreign body sensation and then develops, within a few hours or days, into bilateral keratoconjunctivitis with marked chemosis, epiphora, and photophobia. Visual impairment can persist for months because of subepithelial corneal infiltrates (nummuli) and irregular astigmatism. Randomized clinical trials have not shown any clear benefit in the acute phase from any of a variety of treatments, including steroids, calcineurin inhibitors, virostatic drugs and disinfecting agents. In the chronic phase, cyclosporin A eye drops can accelerate the regression of subepithelial infiltrates. Hygienic measures, including conscientious hand and surface disinfection, can lessen the spread of the disease.CONCLUSION: The first priority in the treatment of patients with definite or suspected EKC is the rigorous application of hygienic measures in medical facilities, particularly because there is still no effective drug treatment for this disease. No virostatic agent has yet been demonstrated to influence its course, either subjectively or objectively.

KW - Adenovirus Infections, Human

KW - Chronic Disease

KW - Cross-Sectional Studies

KW - Cyclosporine

KW - Disease Notification

KW - Disinfection

KW - Epidemics

KW - Germany

KW - Hand Disinfection

KW - Humans

KW - Immunosuppressive Agents

KW - Incidence

KW - Keratoconjunctivitis

KW - Ophthalmic Solutions

KW - Randomized Controlled Trials as Topic

U2 - 10.3238/arztebl.2011.0475

DO - 10.3238/arztebl.2011.0475

M3 - SCORING: Journal article

C2 - 21814523

VL - 108

SP - 475

EP - 480

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

IS - 27

ER -