Newland H S, White A T, Greene B M, Murphy R P, Taylor H R
Dana Center for Preventive Ophthalmology, Wilmer Institute, Johns Hopkins University, Baltimore, Maryland.
Br J Ophthalmol. 1991 Mar;75(3):163-9. doi: 10.1136/bjo.75.3.163.
The epidemiology and natural history of onchocerciasis and its ocular complications in rain forest areas are poorly understood. The present study was conducted on a rubber plantation in a hyperendemic area in the rain forest of Liberia, West Africa, where 800 persons were examined. The prevalence of infection was 84% overall 29% had intraocular microfilariae, and 2.4% were blind in one or both eyes. Onchocerciasis was the cause of all binocular blindness and one-third of all visual impairment. Over half of the visual impairment caused by onchocerciasis was due to posterior segment diseases. Chorioretinal changes were present in 75% of people, and included intraretinal pigment clumping in 52% and retinal pigment epithelium atrophy in 32%. Atrophy of the retinal pigment epithelium was associated with increasing age and severity of infection. Intraretinal pigment was strongly associated with anterior uveitis. There was a strong correlation between uveitis and the inflammatory chorioretinal sequelae: retinitis, intraretinal pigment, subretinal fibrosis, and optic neuropathy. These findings indicate that considerable visual impairment associated with rain forest onchocerciasis is common and is due largely to chorioretinal disease.
人们对盘尾丝虫病及其眼部并发症在雨林地区的流行病学和自然史了解甚少。本研究在西非利比里亚雨林中一个高度流行地区的橡胶种植园进行，对800人进行了检查。总体感染率为84%，29%有眼内微丝蚴，2.4%单眼或双眼失明。盘尾丝虫病是所有双眼失明和三分之一视力损害的病因。盘尾丝虫病导致的视力损害超过一半是由于后段疾病。75%的人有脉络膜视网膜改变，其中52%有视网膜内色素团块，32%有视网膜色素上皮萎缩。视网膜色素上皮萎缩与年龄增长和感染严重程度相关。视网膜内色素与前葡萄膜炎密切相关。葡萄膜炎与炎症性脉络膜视网膜后遗症（视网膜炎、视网膜内色素、视网膜下纤维化和视神经病变）之间存在很强的相关性。这些发现表明，与雨林地区盘尾丝虫病相关的严重视力损害很常见，且主要是由脉络膜视网膜疾病引起的。
