Ocular changes with oral and transepidermal diethylcarbamazine therapy of onchocerciasis

Insights

Topical diethylcarbamazine (DEC) lotion for ocular onchocerciasis showed no benefits over oral DEC. The lotion group experienced more ocular complications, suggesting oral treatment remains preferable for treating this infection.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Parasitology

Background:

  • Onchocerciasis, caused by Onchocerca volvulus, is a significant cause of preventable blindness.
  • Ocular complications of onchocerciasis require effective and safe treatment strategies.

Purpose of the Study:

  • To compare the safety and efficacy of oral diethylcarbamazine (DEC) versus topical DEC lotion for ocular onchocerciasis.
  • To evaluate potential ocular adverse events associated with each treatment method.

Main Methods:

  • A double-masked, controlled clinical trial involving twenty men with moderate Onchocerca volvulus infection.
  • Assessment of visual acuity, color vision, visual fields, and ocular structures over a 6-month period.

Main Results:

  • Both oral and topical DEC treatments resulted in fluffy corneal opacities and intraocular microfilariae.
  • The DEC lotion group showed a higher incidence of new chorioretinal changes and optic atrophy compared to the oral DEC group.
  • No significant changes in visual acuity or color vision were observed in either group.

Conclusions:

  • Topical DEC lotion does not offer advantages over oral DEC for ocular onchocerciasis.
  • Topical DEC lotion may be associated with increased ocular complications compared to oral administration.

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