Ivermectin for onchocercal eye disease (river blindness) (Cochrane Review)

A substantive amendment to this systematic review was last made on 30 November 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: 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.

Objectives: 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.

Search strategy: We searched the Cochrane Controlled Trials Register - CENTRAL/CCTR, which contains the Cochrane Eyes and Vision Group trials register (Cochrane Library Issue 4 2001), MEDLINE (1966 to October 2001), EMBASE (1980 to November 2001), the reference lists of identified trials and the Science Citation Index. We also contacted investigators, experts in the field and pharmaceutical companies to identify additional trials.

Selection criteria: 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 in the trials were people normally resident in endemic onchocercal communities with or without one or more characteristic signs of ocular onchocerciasis.

Data collection and analysis: 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 performed.

Main results: This review includes five trials with data from 3810 participants. All the trials compared ivermectin with placebo. No statistically significant difference was observed in any trial (reporting visual acuity outcome) between ivermectin and placebo groups for visual acuity loss.

Reviewers' conclusions: Questions about the effectiveness of ivermectin in preventing visual acuity loss have not been answered by best available evidence.

Citation: Ejere H, Schwartz E, Wormald R. Ivermectin for onchocercal eye disease (river blindness) (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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