Association Between Initial Corneal Involvement and Duration of Visual Symptoms in Clinically Diagnosed Adenoviral Keratoconjunctivitis

Background: Adenoviral keratoconjunctivitis is a common contagious ocular infection in which corneal involvement may result in persistent subepithelial infiltrates and prolonged visual disturbances. Early identification of patients at risk of delayed visual recovery may facilitate appropriate counselling and follow-up. The aim is to evaluate the association between initial corneal involvement and duration of visual symptoms in clinically diagnosed adenoviral keratoconjunctivitis. Material and Methods: This prospective observational study included 130 patients with clinically diagnosed adenoviral keratoconjunctivitis. Patients were categorized according to the presence or absence of corneal involvement at initial presentation. Clinical findings, visual acuity, corneal manifestations, duration of visual symptoms, and subsequent subepithelial infiltrates were assessed during follow-up. A p-value <0.05 was considered statistically significant. Results: Initial corneal involvement was observed in 72 (55.4%) patients. The mean duration of visual symptoms was significantly longer in patients with corneal involvement than in those without involvement (32.6 ± 14.8 vs 17.4 ± 9.2 days; p<0.001). Visual symptoms persisted beyond 4 weeks in 52.8% versus 15.5% of patients, respectively (p<0.001). Subepithelial infiltrates during follow-up were more frequent in patients with initial corneal involvement (58.3% vs 17.2%; p<0.001). Initial corneal involvement was independently associated with prolonged visual symptoms (adjusted OR 4.62; 95% CI: 1.94–11.02; p<0.001). Conclusion: Initial corneal involvement was significantly associated with prolonged visual symptoms and persistent corneal abnormalities in adenoviral keratoconjunctivitis. Assessment of corneal involvement at presentation may help identify patients at increased risk of delayed visual recovery.

Keywords: Adenoviral keratoconjunctivitis; Corneal involvement; Visual symptoms; Subepithelial infiltrates; Visual acuity; Adenoviral conjunctivitis; Visual recovery.