Evaluation of microfilaricidal effects in the cornea from topically applied drugs in ocular onchocerciasis: Trials with levamisole and mebendazole.

Increasing concentrations of levamisole and of mebendazole were applied to 1 eye in groups of 4 patients with ocular onchocerciasis in northern Cameroon. No effect resulted from up to 3.0% mebendazole suspensions, but 3.0% levamisole solutions rapidly caused entry of microfilariae, straightening out and subsequent opacification of previously curled-up living microfilariae, the rapid formation of typical limbal globular infiltrates, and the subsequent formation of fluffy opacities around the microfilariae. These changes are typical of all other drugs so far studied that have a microfilaricidal action on O. volvulus--diethlycarbamizine citrate (DEC), suramin, and metrifonate. The efficacy of 3.0% levamisole approximated to that of 0.03% DEC. This is in keeping with published observations on the filaricidal activity of these 2 compounds. It is suggested that this system of drug testing should be considered for systematic use in the search for more effective and safer drugs for onchocerciasis.