Assessment of a rapid adenoviral detection test for confirmation of adenoviral conjunctivitis.

1. Atul B. SHAH*
2. Anita NG
3. Pat USHER
4. Carmel Crock
5. Lucy BUSIJA

1. *West of England Eye Unit, Exeter, UK
2. Royal Victorian Eye and Ear Hospital (RVEEH), Melbourne, Australia,

Objective: Feasibility study for incorporation of a Rapid Pathogen Screening (RPS) Adeno Detector test (an immuno-chromatographic test that detects adenoviral antigens directly from eye fluids, RPS, Inc., South Williamsport, PA, USA) in regular clinical practice for confirmation of adenoviral conjunctivitis and evaluation of the sensitivity and specificity of the test using adenoviral PCR as the gold standard.

Methods: A total of 108 patients with presumptive diagnoses of viral conjunctivitis were recruited from the RVEEH Emergency Department. Participants were first swabbed for the RPS Adeno Detector test (as per manufacturer instructions) then again for the viral PCR test. The test result was read and recorded on the provided proforma by a trained recruiter. The viral PCR test result was followed up by the investigator and recorded on the same proforma.

Results: Preliminary results from the study show that the RPS Adeno Detector test is 54.5% sensitive (95% CI 41.1% - 69.6%) and 82.8% (95% CI 68.7% - 88.9%) specific. The test has a positive predictive value of 68.6% and a negative predictive value of 72.6%. These results are at variance and substantially lower than previously reported values of a sensitivity of 89% and specificity of 94% for the RPS Adeno Detector test, (Ophthalmology 2006; 113 (10): 1758-1764).

Conclusion: The results suggest that the RPS Adeno Detector test has moderately high specificity but low sensitivity for use as a sole test to confirm adenoviral conjunctivitis in a busy emergency department or a physician's office.