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Jul 15, 2024Keywords:
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Evaluation of near point of convergence and amplitude of accommodation after treatment of malaria with artemether-lumefantrine
Abstract
Background: Malaria induces a recession of the near point of convergence and a reduction of the amplitude of accommodation of the eye with symptoms such as blurred vision at near, difficulty reading, asthenopia, exophoria at near, and low accommodative convergence ratio occurring, all these symptoms lead to an interference in visual functioning and performance. Artemether- Lumefantrine anti-malaria drug is widely used and very effective as a first line treatment for uncomplicated plasmodium falciparum malaria infection. There is a need to determine if artemether-lumefantrine can reverse the effects of malaria on the amplitude of accommodation and near point of convergence.
Methods: This was a clinical study carried out using the convenient sampling method at the medical center and department of Optometry teaching clinic of the Federal University of Technology Owerri, Imo State, Nigeria to evaluate amplitude of accommodation and near point of convergence after treatment with artemether-lumefantrine. Informed consent was obtained from all subjects that participated in the study and ethical clearance from the Ethics Committee of the School of Health Technology, Federal University of Technology, Owerri. 143 subjects aged 18 to 30 years diagnosed with malaria were recruited for the study. The amplitude of accommodation was measured using the push-up to blur method with an accommodative target, and near point of convergence was determined using the push-up to break and recovery method with an accommodative target. Both measurements were taken after the diagnosis of malaria was made through laboratory analysis and before the administration of the drug. After drug administration, amplitude of accommodation and near point of convergence measurements were repeated 24-, 48-, 72-, and 336 hours. Effects of drug administration on parameters were analyzed using T-test and ANOVA.
Results: There was a significant increase in the amplitude of accommodation with time following administration of artemether-lumefantrine drug combination (p<0.001) while near point of convergence was not affected (p>0.05).
Conclusion: Artemether-lumefantrine used for the treatment of malaria countered the effect of malaria parasite on amplitude of accommodation by increasing it but had no significant effect on near point of convergence.
