Dadzie K Y, Bird A C, Awadzi K, Schulz-Key H, Gilles H M, Aziz M A
Br J Ophthalmol. 1987 Feb;71(2):78-85. doi: 10.1136/bjo.71.2.78.
The effect of ivermectin, a new microfilaricide, was assessed in a double blind trial against diethylcarbamazine citrate (DEC) and placebo. Fifty-nine adult males with moderate to heavy infection with Onchocerca volvulus and with eye involvement were recruited from an area under Onchocerciasis Control Programme (OCP) vector control in Northern Ghana. They were randomly assigned to an eight-day treatment with ivermectin as a single dose of 12 mg on day 1 followed by placebo for the remaining seven days, or DEC, total dose 1.3 g, or placebo, and ophthalmological review was undertaken over a period of one year. DEC acted quickly to eliminate microfilariae from the eye and was associated with reactive ocular changes and in a few cases functional deficit. Ivermectin eliminated microfilariae slowly from the anterior chamber of the eye over a period of six months. The ocular inflammatory reaction was minimal and no functional deficit occurred. It is postulated that the observed slow action of ivermectin on the eye may be attributed in part to its instability to cross the blood-aqueous humour barrier because of its molecular size as a macrocyclic lactone causing microfilariae to leave the eye gradually along a newly created gradient. Ivermectin is an effective microfilaricide with minimal ocular adverse effect and could therefore be suitable for widespread application without strict supervision.
在一项双盲试验中，对一种新型杀微丝蚴剂伊维菌素与枸橼酸乙胺嗪（DEC）及安慰剂进行了疗效评估。从加纳北部盘尾丝虫病控制计划（OCP）病媒控制区域招募了59名中度至重度感染盘尾丝虫且有眼部受累的成年男性。他们被随机分配接受为期8天的治疗，一组在第1天单次服用12毫克伊维菌素，其余7天服用安慰剂；另一组服用总剂量为1.3克的DEC；还有一组服用安慰剂，并在一年时间内进行眼科检查。DEC能迅速清除眼部微丝蚴，但会引发眼部反应性变化，少数情况下还会导致功能缺陷。伊维菌素在六个月的时间里缓慢地从眼前房清除微丝蚴。眼部炎症反应轻微，未出现功能缺陷。据推测，观察到的伊维菌素对眼睛的缓慢作用可能部分归因于其作为大环内酯类药物，因分子大小而难以穿过血-房水屏障，导致微丝蚴沿着新形成的梯度逐渐离开眼睛。伊维菌素是一种有效的杀微丝蚴剂，眼部不良反应极小，因此无需严格监管即可广泛应用。
