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Ocular changes with oral and transepidermal diethylcarbamazine therapy of onchocerciasis
Abstract:
Twenty men with moderate infection of Onchocerca volvulus were studied in a double-masked, controlled clinical trial to compare the safety and efficacy of oral diethylcarbamazine (DEC) with topical DEC lotion. Visual acuity and colour vision did not alter during the 6 months of observation, although 2 patients receiving DEC lotion and 3 patients receiving oral DEC developed either visual field constriction or optic atrophy. Fluffy corneal opacities were common in both groups. Intraocular microfilariae also appeared in both groups but to a greater extent in those receiving DEC lotion. New chorioretinal changes developed in 4 men receiving lotion and in only 1 receiving tablets. It is concluded that DEC lotion offers no advantage over tablets in the treatment of ocular onchocerciasis and in fact may be associated with more ocular complications than the conventional oral treatment.
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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