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OCULAR CHANGES IN PATIENTS INFECTED WITH THE FILARIAL NEMATODE ONCHOCERCA VOLVULUS IN SOUTHWESTERN SUDAN
Author(s) -
JUSTIN O'DAY,
BSC CHARLES D. MACKENZIE,
BVSC JEFFREY F. WILLIAMS
Publication year - 1984
Publication title -
australian journal of opthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 0310-1177
DOI - 10.1111/j.1442-9071.1984.tb01158.x
Subject(s) - onchocerciasis , onchocerca volvulus , medicine , posterior segment of eyeball , pathology , pathological , ophthalmology
Ophthalmological examination of 417 patients with onchocerciasis in southwestern Sudan, a woodland savannah region, showed that ocular disease is a major health problem in these patients. Visual acuity was severely impaired in approximately 6% of patients and was reduced to finger counting in some individuals as young as 16 years. Pathological changes seen in the cornea ranged from punctate opacification to more severe sclerosing keratitis; the punctate lesions were more common in juveniles than adults. These punctate lesions were often associated with degenerating microfilariae, and a hypothetical sequence of their development is presented. Posterior segment lesions varied from mild focal retinal pigment changes, visible as dots, to widespread chorioretinal atrophy. Optic atrophy and vascular sheathing were also seen and were found exclusively in adults. These ocular changes are consistent with the findings of workers in other endemic areas who attributed them to onchocerciasis. Additional changes seen in this study included dispersal of pigment in the anterior chamber, iritis with seclusion of the pupil, and cataracts. These findings are discussed in the light of current knowledge of the pathogenesis of the disease and the need for further research into its immunopathology.