[Ivermectin and human onchocerciasis. A study of 234 onchocerciasis patients in the Republic of Mali]. / Ivermectine et onchocercose humaine. A propos d'une étude portant sur 234 onchocerquiens en République du Mali.

In a double blind study Ivermectin has been compared to a placebo in 234 male and female with onchocerciasis who had more than 20 microfilariae per milligram of skin and moderate ocular involvement. Patient was randomized to receive a simple oral dose of Ivermectin 100, 150 and 200 micrograms/kg or placebo. The following was 12 months. The decrease of microfilarodermia since to the 3rd day was from 72.8 to 79.3% of initial rate. At six months it was more than 91% and more than 87% in 12 months. Ocular microfilariae, initially between 12 and 23 stay lower than 2 at 12 months. Punctuated keratitis disappear and did not recidive still 6 months in patients with persistent microfilariae. Ivermectin produce only few side effects. Negative waves have been observed on ECG but without any clinical signs. The Power efficient dose seen to be 100 micrograms/kg.

[Orbital and ocular tumors in the Republic of Mali]. / Les tumeurs orbito-oculaires en République du Mali.

Analysing 82 cases of oculo-orbital tumours in Malian patients, the authors find the classical features characterizing ocular carcinoma in Africa, i.e. early arising, development, late request for treatment. They stress on the age of the patients at the occasion of the first request for treatment in case of retinoblastoma, and notice the special frequency of squamous cell carcinoma with conjunctival or limbic localization.

[Technics and results of autografts in surgery of pterygium. Study based on 34 grafts]. / Techniques et résultats des autogreffes dans la chirurgie du ptérygion. Etude portant sur 34 greffes.

The first procedure consists of corneal autograft sampled at noon or six o'clock on the pterygium's excision bed, combined to a conjunctival flaps translation. The second technique consists of a monoblock corneoconjunctival graft with a limbic hinge. The operative difficulties, post-surgical complications and results are discussed. The results seem very promising: one recurring case out of 34 grafts performed. The recurring risk, more acute in tropical environment where it is frequently impossible to obtain corneal homografts is greatly reduced by autografts.

[Artificial lenses at the Institute of Tropical Ophthalmology of Africa]. / Les cristallins artificiels à l'Institut d'Ophtalmologie Tropicale de l'Afrique (I.O.T.A.).

The authors present a report on the first set of twenty-three intra-ocular lenses fitting on subjects from Mali, performed at the "Tropical African Ophthalmology Institute" (I.O.T.A.) from december 1983 up to december 1984. This report deals mainly about the implants of the inner aqueous chamber of the eye after the intracapsular extraction. The mechanical complications and inflammatory corneal and retinal consequences which occurred after the surgical operation are being tested. None of these complications has questioned the visual and functional prognosis. So, the results seem quite good. Nevertheless, the mass-surgery concerning the cataract with the fixing of an intra-ocular lens will be able to be considered when the cost of the implants is materially reduced.

Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement.

In a randomised double-blind study, ivermectin was compared with diethylcarbamazine (DEC) and placebo in the treatment of onchocerciasis in 30 male patients from Mali with moderate to heavy Onchocerca volvulus infections and ocular involvement. 10 patients received a single oral dose of ivermectin, 12 mg, 10 received DEC daily for eight days (total dose 1.3 g), and 10 received matching placebo. Patients were examined periodically for twelve months. Punctate keratitis disappeared in 6 of 7 ivermectin patients but increased in DEC patients. Numbers of O volvulus microfilariae (mf) in the anterior chamber decreased slowly and eventually disappeared in most ivermectin patients during the six months following treatment; anterior chamber mf disappeared more rapidly in some patients after DEC, but reappeared within six months of stopping treatment. Both ivermectin and DEC caused a prompt decrease in mean skin mf density; density then increased in both groups over the twelve month observation period, reaching 9% of pretreatment values in ivermectin patients and 45% in the DEC group. Analysis of adult O volvulus from nodules excised at three and twelve months post treatment showed no effect of either drug on viability; however, there was evidence of degeneration of intra-uterine developing mf in the ivermectin group. Side-effects were less frequent and less severe in ivermectin patients than in DEC patients. Ivermectin as a single oral dose appears to be a more effective microfilaricidal drug than DEC in onchocerciasis.