title: Longitudinal study of lesions of the posterior segment in onchocerciasis.
abstract: Onchocerciasis is a major cause of blindness, and much of the blindness due to onchocerciasis is caused by chorioretinitis. Little is known about the progression of lesions in the posterior segment in either untreated or treated disease. The authors studied the progression of onchocercal chorioretinitis in 57 patients from 1 to 3 years. Changes were documented from detailed ocular examinations, fundus photographs, and fluorescein angiograms, and included live intraretinal microfilariae, intraretinal hemorrhages, cotton-wool opacities, intraretinal pigment, white and shiny intraretinal deposits, retinal pigment epithelial window defects, and atrophy. Depigmentation at the edge of chorioretinal scarring progressed at a rate of up to 200 microns per year. Ivermectin or mebendazole treatment did not appear to alter the progress of depigmentation at the edge of chorioretinal scars. These observations suggest that onchocercal chorioretinitis is associated with early changes in the retina and retinal pigment epithelium, and that disease in the posterior segment may progress rapidly.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21205.
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: R P
authors.initials: RP
authors.lastname: Murphy
authors.forename: H S
authors.initials: HS
authors.lastname: Newland
authors.forename: K
authors.initials: K
authors.lastname: Awadzi
authors.forename: B M
authors.initials: BM
authors.lastname: Greene
authors.forename: H R
authors.initials: HR
authors.lastname: Taylor
mesh_terms: D000818:Animals; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008137:Longitudinal Studies; D008463:Mebendazole / Q000627:therapeutic use; D008842:Microfilariae / Q000254:growth & development; D015827:Onchocerciasis, Ocular / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D009896:Optic Atrophy / Q000209:etiology; D010857:Pigment Epithelium of Eye / Q000473:pathology; D011897:Random Allocation; D012160:Retina / Q000469:parasitology / Q000473:pathology; D012166:Retinal Hemorrhage / Q000209:etiology; D012168:Retinal Pigments
chemical_list: D012168:Retinal Pigments; D007559:Ivermectin; D008463:Mebendazole