title: Treatment of onchocerciasis. The ocular effects of ivermectin and diethylcarbamazine.
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 micrograms/kg), diethylcarbamazine (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. Ivermectin 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.
mesh_terms: D000328:Adult; D000871:Anthelmintics / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004049:Diethylcarbamazine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005123:Eye / Q000187:drug effects*; D005128:Eye Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007559:Ivermectin; D007783:Lactones / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008842:Microfilariae / Q000187:drug effects; D008875:Middle Aged; D009854:Onchocerca / Q000187:drug effects; D009855:Onchocerciasis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D011897:Random Allocation; D012160:Retina / Q000469:parasitology; D013997:Time Factors
chemical_list: D000871:Anthelmintics; D007783:Lactones; D007559:Ivermectin; D004049:Diethylcarbamazine