Further studies on the treatment of ocular onchocerciasis with diethylcarbamazine and suramin.

The purpose of the present study was to determine whether or not the elimination of microfilariae by diethylcarbamazine citrate (DEC) would reduce the side effects of a subsequent course of suramin and thus make it more acceptable and safer in the treatment of onchocerciasis. Fifty-four heavily infected patients with ocular onchocerciasis were treated with an initial 2-week course of DEC, in which the dose was increased slowly from 25 mg on the first day to 150 to 200 mg twice daily on days 8 to 14. Betamethasone 1P5 mg was given twice daily 2 days before DEC administration, and during the days of increasing DEC dosage, after which it was tailed off. This course was followed by 3 to 5 weekly injections of suramin. It was found possible to rid these heavily infected patients of most of their microfilariae during the initial course without intolerable side effects. The subsequent suramin course was in general well accepted except in 1 case, where After treatment there was a serious aggravation of anterior Lesions Before New uveitis. The later development of retinal pigtreatment Better Same Worse lesions ment atrophy in 3 patients, of optic atrophy in Sclerosing keratitis 18 15 3 0 0 3 others, and of both retinal and optic atrophy Iritis 30 24 6 0 0 in 1 patient is discussed. Glaucoma 5 0 2 3 0 The effects of this regimen on eye lesions Choroidoretinitis 25 0 20 5 4 and visual acuity at the final examinations (1 to 4 Optic atrophy 19 0 19 0 4 years) compared favourably with those from our Optic nerve congestion 6 0 0 6 0 previous trial of suramin given alone or followed Visual acuity (eycs) 108 13 73 22 by DEC, and they can be summarised as follows: