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Treatment of OnchocerciasisThe Ocular Effects of Ivermectin and Diethylcarbamazine
Hugh R. Taylor, MD;
Robert P. Murphy, MD;
Henry S. Newland, FRACS;
Albert T. White, MD;
Salvatore A. D'Anna;
Ezatollah Keyvan-Larijani, MD;
Mohammed A. Aziz, MD;
Edward W. Cupp, PhD;
Bruce M. Greene, MD
Arch Ophthalmol. 1986;104(6):863-870.
Abstract
• The ocular changes that occur with diethylcarbamazine treatment of onchocerciasis seriously restrict its usefulness. Ivermectin, a newly developed antifilarial drug, was compared with diethylcarbamazine for treatment of onchocerciasis in a double-masked, placebo-controlled trial. Thirty men with moderate to severe infection and ocular involvement were randomly assigned to receive ivermectin as a single oral dose (200 µg/kg), diethylcarbamzine (administered for eight days), or placebo. Detailed ocular examinations were performed serially over a 12-month period. Diethylcarbamazine treatment caused a marked increase in living and dead microfilariae in the cornea, punctate opacities, and limbitis during the first week of therapy. lvermectin had no such effect. However, ivermectin therapy resulted in a long-term reduction in intraocular microfilariae comparable to that seen with diethylcarbamazine. Ivermectin appears to have few ocular complications and be a better-tolerated and more effective microfilaricidal agent than diethylcarbamazine for the treatment of onchocerciasis.
Author Affiliations
From the Ocular Onchocerciasis Research Unit, Dana Center for Preventive Ophthalmology, The Wilmer Institute, The Johns Hopkins University, Baltimore (Drs Taylor, Murphy, Newland, and Keyvan-Larijani and Mr D'Anna); the Department of Medicine, Case Western Reserve University and University Hospitals, Cleveland (Drs White and Greene); Merck Sharpe & Dohme Research Laboratories, Rahway, NJ (Dr Aziz); and the Department of Entomology, Cornell University, Ithaca, NY (Dr Cupp).
Footnotes
Accepted for publication Dec 6, 1985.
Reprint requests to The Wilmer Institute, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205 (Dr Taylor).
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