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. 1987 Feb;71(2):78–85. doi: 10.1136/bjo.71.2.78

Ocular findings in a double-blind study of ivermectin versus diethylcarbamazine versus placebo in the treatment of onchocerciasis.

K Y Dadzie, A C Bird, K Awadzi, H Schulz-Key, H M Gilles, M A Aziz
PMCID: PMC1041095  PMID: 3548811

Abstract

The effect of ivermectin, a new microfilaricide, was assessed in a double blind trial against diethylcarbamazine citrate (DEC) and placebo. Fifty-nine adult males with moderate to heavy infection with Onchocerca volvulus and with eye involvement were recruited from an area under Onchocerciasis Control Programme (OCP) vector control in Northern Ghana. They were randomly assigned to an eight-day treatment with ivermectin as a single dose of 12 mg on day 1 followed by placebo for the remaining seven days, or DEC, total dose 1.3 g, or placebo, and ophthalmological review was undertaken over a period of one year. DEC acted quickly to eliminate microfilariae from the eye and was associated with reactive ocular changes and in a few cases functional deficit. Ivermectin eliminated microfilariae slowly from the anterior chamber of the eye over a period of six months. The ocular inflammatory reaction was minimal and no functional deficit occurred. It is postulated that the observed slow action of ivermectin on the eye may be attributed in part to its instability to cross the blood-aqueous humour barrier because of its molecular size as a macrocyclic lactone causing microfilariae to leave the eye gradually along a newly created gradient. Ivermectin is an effective microfilaricide with minimal ocular adverse effect and could therefore be suitable for widespread application without strict supervision.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J., Fuglsang H., de C Marshall T. F. Effects of diethylcarbamazine on ocular onchocerciasis. Tropenmed Parasitol. 1976 Sep;27(3):263–278. [PubMed] [Google Scholar]
  2. Anderson J., Fuglsang H., de C Marshall T. F. Effects of suramin on ocular onchocerciasis. Tropenmed Parasitol. 1976 Sep;27(3):279–296. [PubMed] [Google Scholar]
  3. Awadzi K., Dadzie K. Y., Shulz-Key H., Haddock D. R., Gilles H. M., Aziz M. A. The chemotherapy of onchocerciasis X. An assessment of four single dose treatment regimes of MK-933 (ivermectin) in human onchocerciasis. Ann Trop Med Parasitol. 1985 Feb;79(1):63–78. [PubMed] [Google Scholar]
  4. Aziz M. A., Diallo S., Diop I. M., Lariviere M., Porta M. Efficacy and tolerance of ivermectin in human onchocerciasis. Lancet. 1982 Jul 24;2(8291):171–173. doi: 10.1016/s0140-6736(82)91026-1. [DOI] [PubMed] [Google Scholar]
  5. Bird A. C., el-Sheikh H., Anderson J., Fuglsang H. Changes in visual function and in the posterior segment of the eye during treatment of onchocerciasis with diethylcarbamazine citrate. Br J Ophthalmol. 1980 Mar;64(3):191–200. doi: 10.1136/bjo.64.3.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Campbell W. C., Fisher M. H., Stapley E. O., Albers-Schönberg G., Jacob T. A. Ivermectin: a potent new antiparasitic agent. Science. 1983 Aug 26;221(4613):823–828. doi: 10.1126/science.6308762. [DOI] [PubMed] [Google Scholar]
  7. Coulaud J. P., Lariviere M., Aziz M. A., Gervais M. C., Gaxotte P., Deluol A. M., Cenac J. Ivermectin in onchocerciasis. Lancet. 1984 Sep 1;2(8401):526–527. doi: 10.1016/s0140-6736(84)92608-4. [DOI] [PubMed] [Google Scholar]
  8. Coulaud J. P., Larivière M., Gervais M. C., Gaxotte P., Aziz A., Deluol A. M., Cenac J. Traitement de l'onchocercose humaine par l'ivermectine. Bull Soc Pathol Exot Filiales. 1983 Nov;76(5):681–688. [PubMed] [Google Scholar]
  9. D'HAUSSY R., RIT J. M., LAGRAULET J. Contribution à l'étude des lésions du fond d'oeil dans l'onchocercose. Med Trop (Mars) 1958 Mar-Apr;18(2):340–367. [PubMed] [Google Scholar]
  10. Degabriel J., Lucot J., Chovet M. Onchocercose: critères d'évaluation des résultats d'une campagne thérapeutique en mileeu rural. Med Trop (Mars) 1970 Nov-Dec;30(6):795–800. [PubMed] [Google Scholar]
  11. Duke B. O., Vincelette J., Moore P. J. The populatin dynamics of Onchocerca volvulus microfilariae during treatment with suramin and diethylcarbamazine. Tropenmed Parasitol. 1976 Jun;27(2):133–144. [PubMed] [Google Scholar]
  12. Greene B. M., Taylor H. R., Cupp E. W., Murphy R. P., White A. T., Aziz M. A., Schulz-Key H., D'Anna S. A., Newland H. S., Goldschmidt L. P. Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis. N Engl J Med. 1985 Jul 18;313(3):133–138. doi: 10.1056/NEJM198507183130301. [DOI] [PubMed] [Google Scholar]
  13. Jones B. R., Anderson J., Fuglsang H. Effects of various concentrations of diethylcarbamazine citrate applied as eye drops in ocular onchocerciasis, and the possibilities of improved therapy from continuous non-pulsed delivery. Br J Ophthalmol. 1978 Jul;62(7):428–439. doi: 10.1136/bjo.62.7.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lariviere M., Vingtain P., Aziz M., Beauvais B., Weimann D., Derouin F., Ginoux J., Schulz-Key H., Gaxotte P., Basset D. Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement. Lancet. 1985 Jul 27;2(8448):174–177. doi: 10.1016/s0140-6736(85)91496-5. [DOI] [PubMed] [Google Scholar]
  15. Lazar M., Lieberman T. W., Furman M., Leopold I. H. Ocular penetration of hetrazan in rabbits. Am J Ophthalmol. 1968 Aug;66(2):215–220. doi: 10.1016/0002-9394(68)92066-7. [DOI] [PubMed] [Google Scholar]
  16. QUERE M. A., LARIVIERE M., RAZAFINJATO R. LES COMPLICATIONS OCULAIRES DE L'ONCHOCERCOSE: PROBL'EME DU PRONOSTIC VISUEL CHEZ LES SUJETS TRAIT'ES. Bull Soc Med Afr Noire Lang Fr. 1965;10:19–21. [PubMed] [Google Scholar]
  17. RODGER F. C. Comparison of the effect upon onchocerciasis of five drugs and selection of the one best able to prevent ocular complications. Trans R Soc Trop Med Hyg. 1958 Sep;52(5):462–467. doi: 10.1016/0035-9203(58)90134-2. [DOI] [PubMed] [Google Scholar]
  18. Rodger F. C. Selective preventive treatment of onchocerciasis. Isr J Med Sci. 1972 Aug-Sep;8(8):1163–1165. [PubMed] [Google Scholar]
  19. TOULANT P. F., BOITHIAS R. Les lésions oculaires de l'onchocercose africaine. Med Trop (Mars) 1954 Mar-Apr;14(2):191–199. [PubMed] [Google Scholar]
  20. Thylefors B., Rolland A. The risk of optic atrophy following suramin treatment of ocular onchocerciasis. Bull World Health Organ. 1979;57(3):479–480. [PMC free article] [PubMed] [Google Scholar]
  21. Toufic N. Les difficultés thérapeutiques de l'onchocercose oculaire. Arch Ophtalmol Rev Gen Ophtalmol. 1969 Nov;29(11):777–784. [PubMed] [Google Scholar]
  22. Vedy J., Sirol J. A propos d'une papillite onchocerquienne. Med Trop (Mars) 1971 Sep-Oct;31(5):559–564. [PubMed] [Google Scholar]

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