Kelvin Nkuma, Nwakaego Ikoro, Victoria Nkemka, Emmanuel Esenwah, Young Azuamah, Genevieve Ugwoke, Megwas Anthony, Lilian Umunnakwe
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, an antimalarial drug, is widely used and highly effective as a first-line treatment for uncomplicated Plasmodium falciparum malaria infections. 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 conducted using the convenience sampling method at the medical centre and the department of Optometry teaching clinic of the Federal University of Technology, Owerri, Imo State, Nigeria, to evaluate the amplitude of accommodation and near point of convergence after treatment with artemether-lumefantrine. Informed consent was obtained from all participants in the study, and ethical clearance was obtained from the Ethics Committee of the School of Health Technology at the Federal University of Technology, Owerri. One hundred forty-three 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 the 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 at 24-, 48-, 72-, and 336-hour intervals. Effects of drug administration on parameters were analysed using the 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.
Keywords: Malaria, Artemether-Lumefantrine, Amplitude of Accommodation, Near Point of Convergence.