Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions

Labib, Bisant A; Minhas, Bhawanjot K; Chigbu, DeGaulle I

CDV is likely due to changes in amino acid sequence within the encoded DNA polymerase genes in resistant HAdV, which has been suggested to confer resistance of adenovirus to CDV. Drug resistance poses a significant challenge to the management of adenoviral keratoconjunctivitis in the clinical setting. 53 Romanowski et al were able to demonstrate that HAdV type 5 that are resistant to topical CVD therapy are less likely to constitute a significant challenge in management of adenoviral keratoconjunctivitis in immunocompetent patients. Drugresistant viruses usually pose a minimal threat in immunocompetent patients, but CDV-resistant HAdV can retain their ability to replicate in permissive ocular epithelial cells. 54 Another major challenge to the use of CDV for treating adenoviral keratoconjunctivitis is its propensity to lead to toxicity, which manifests as persistent epiphora from lacrimal canalicular blockade. 53 As such, despite its potential, its high toxicity profile and poor bioavailability make CDV a less than ideal treatment option for the treatment of HAdV associated infections, both systemically and locally.