Investigating Epstein-Barr Virus Associated Conjunctivitis (EBV Conj)

Conjunctivitis means inflammation of the conjunctiva, the thin transparent layer over the white of the eye and under the eyelids. Acute conjunctivitis caused by infection is the most common condition seen in ophthalmic emergency departments, accounting for up to 10% of cases. It is responsible for 41% of eye-related general practice consultations. A diagnosis is usually made on the patient's symptoms and signs, despite this being less reliable than laboratory testing. When a cause is found, it is usually a common cold virus called adenovirus, that gets better with time and does not require treatment.

Through investigating cases of conjunctivitis at Moorfields, it has been discovered that in addition to adenovirus, Epstein Barr virus (EBV) is sometimes detected in conjunctival swabs from individuals with conjunctivitis. EBV is a very common viral infection that 95% of adults have experienced. EBV infection mostly passes unnoticed but when symptoms do occur, they include a sore throat, high temperature, swollen glands and tiredness, often called glandular fever or infectious mononucleosis. Conjunctivitis can also occur. EBV remains in the body after infection and rarely causes further problems. The virus can become active again occasionally, which is known as reactivation.

Reactivation usually passes unnoticed but sometimes is associated with recurrence of symptoms. It is possible that reactivation may cause conjunctivitis. It is not certain, which is will be observed as a part of this study, as it might be the cause of some of the conjunctivitis seen.

Through a collaboration with University College London (UCL), the aim is to gain further insight into infectious conjunctivitis, particularly in relation to EBV. This will be done by taking a swab of the conjunctiva, a single blood test and a tiny (1-2mm) tissue sample from the inner eyelid. Improved knowledge will allow the research team to develop better guidance and treatment for patients with conjunctivitis.

Study Overview

• Status: Enrolling by invitation
• Conditions: Conjunctivitis; EBV Infection

• Study Type: Observational
• Enrollment (Estimated): 5

Contacts and Locations

Study Locations

• United Kingdom
  • London, United Kingdom, EC1V 2PD
    • Moorfields Eye Hospital NHS Foundation Trust

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited from Moorfields A&E. Eligible patients will be identified by a member of the clinical triage team. All eligible patients will be enrolled during the study period.

Description

Inclusion Criteria:

• Participants shall be considered eligible for inclusion if:

  • Aged ≥16 years;
  • working diagnosis of infective (viral) follicular conjunctivitis (<4 weeks duration)
  • EBV positive conjunctival swab

Exclusion Criteria:

• • Present with symptoms/signs such that another diagnosis is deemed more likely, for example topical medication-induced conjunctivitis.

  • Participant declines diagnostic tests or appropriate corneal or conjunctival sample(s) not obtained for any reason

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The number of participants with clinically suspected viral conjunctivitis in which EBV DNA is identified on NAAT.	To confirm the proportion of: participants with clinically suspected viral conjunctivitis in which EBV DNA is identified on NAAT.; EBV NAAT-positive participants who have a new EBV infection versus those with a reactivation of earlier disease.; participants in whom EBV is confirmed the cause of conjunctivitis on further investigation.	From enrollment to the end of visit 2 which can occur within up to 7 days from enrollment.

Collaborators and Investigators

• Sponsor: Moorfields Eye Hospital NHS Foundation Trust

Study record dates

Study Major Dates

• Study Start (Actual): October 9, 2024
• Primary Completion (Estimated): June 2, 2025
• Study Completion (Estimated): June 2, 2025

Study Registration Dates

• First Submitted: September 8, 2024
• First Submitted That Met QC Criteria: November 13, 2024
• First Posted (Estimated): November 14, 2024

Study Record Updates

• Last Update Posted (Estimated): November 14, 2024
• Last Update Submitted That Met QC Criteria: November 13, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections; Virus Diseases; Eye Diseases; DNA Virus Infections; Herpesviridae Infections; Tumor Virus Infections; Conjunctival Diseases; Conjunctivitis; Epstein-Barr Virus Infections
• Other Study ID Numbers: LARF1028; 342525 (Other Identifier: IRAS); 24/YH/0160 (Other Identifier: Research Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No