Ejere H, Schwartz E, Wormald R
International Health Division, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK, L3 5QA.
Cochrane Database Syst Rev. 2001(1):CD002219. doi: 10.1002/14651858.CD002219.
It is believed that ivermectin (a microfilaricide) could prevent blindness due to onchocerciasis. However, when given to everyone in communities where onchocerciasis is common, the effects of ivermectin on lesions affecting the eye are uncertain and data on whether the drug prevents visual loss is unclear.
The aim of this review is to assess the effectiveness of ivermectin in preventing visual acuity and visual field loss in onchocercal eye disease. The secondary aim is to assess the effects of ivermectin on lesions affecting the eye in onchocerciasis.
We searched the Cochrane Eyes and Vision Group specialised register, the Cochrane Controlled Trials Register - CENTRAL, MEDLINE, EMBASE, the reference lists of identified trials, the Science Citation Index and we contacted investigators, experts and pharmaceutical companies to identify additional trials.
We included randomised controlled trials with at least one year follow up, comparing ivermectin at a dose of 150 micrograms per kilogram of body weight with either placebo or no treatment. Participants were people normally resident in endemic onchocercal communities with or without one or more characteristic signs of ocular onchocerciasis.
Two reviewers independently extracted data and assessed trial quality. Study authors were contacted for additional information. Trials varied in design and setting, so no meta-analysis was done.
This review includes five trials with data from 3810 participants. All the trials compared ivermectin with placebo and were judged to be of moderate risk of bias in terms of methodological quality. No statistically significant difference was observed in any trial (reporting visual acuity outcome) between ivermectin and placebo groups for visual acuity loss.
REVIEWER'S CONCLUSIONS: Questions about the effectiveness of ivermectin in preventing visual acuity loss have not been answered by best available evidence.
人们认为伊维菌素（一种杀微丝蚴剂）可预防盘尾丝虫病导致的失明。然而，在盘尾丝虫病常见的社区给所有人使用伊维菌素时，其对眼部病变的影响尚不确定，且关于该药物能否预防视力丧失的数据也不明确。
本综述的目的是评估伊维菌素在预防盘尾丝虫性眼病患者视力和视野丧失方面的有效性。次要目的是评估伊维菌素对盘尾丝虫病眼部病变的影响。
我们检索了Cochrane眼科和视力组专业注册库、Cochrane对照试验注册库 - CENTRAL、MEDLINE、EMBASE、已识别试验的参考文献列表、科学引文索引，并联系了研究者、专家和制药公司以识别其他试验。
我们纳入了至少随访一年的随机对照试验，将每千克体重150微克剂量的伊维菌素与安慰剂或不治疗进行比较。参与者为通常居住在盘尾丝虫病流行社区的人群，有无盘尾丝虫性眼病的一种或多种特征性体征。
两名综述作者独立提取数据并评估试验质量。联系研究作者获取更多信息。试验在设计和背景方面存在差异，因此未进行荟萃分析。
本综述纳入了五项试验，有3810名参与者的数据。所有试验均将伊维菌素与安慰剂进行比较，就方法学质量而言，判定为存在中度偏倚风险。在任何试验（报告视力结果）中，伊维菌素组和安慰剂组在视力丧失方面均未观察到统计学上的显著差异。
现有最佳证据尚未回答伊维菌素在预防视力丧失方面有效性的问题。
