Comparative Analysis of Four-Week Versus Six-Week Albendazole Therapy in Peri-Ocular Cysticercosis: A Retrospective Study

Background: To compare the efficacy and safety of four-week and six-week treatment regimens for ocular cysticercosis. Method: This was a retrospective study where medical records of patients diagnosed with peri-ocular cysticercosis from January 2018 to March 2025 at a tertiary eye care centre in North India were reviewed. Patients who were treated using albendazole and steroids with either four-week or six-week regimen were included. The primary outcome measures were cyst resolution as assessed by B-scan, symptomatic relief which was assessed by improvement in amount of ptosis , ocular motility, and diplopia grade at follow-up, and secondary outcome measures were safety and recurrence. Result: Eighty-three patients were included in the study with 44 patients in the four-week group and 39 patients in the six-week group. Both groups showed marked clinical improvement, with 100% regression of ptosis, complete improvement of extraocular movement restriction, and cyst collapse on B-scan in all patients. However, residual diplopia in extreme gaze persisted in 56% of the four-week regimen ( P = 0.55), whereas the six-week regimen achieved 84% complete remission ( P = 0.045). Both regimens were well tolerated. Conclusion: Both four-week and six-week regimens are effective in managing peri-ocular cysticercosis. However, the six-week regimen is more beneficial in controlling residual diplopia, even in extreme gaze. The duration of treatment should be tailored as per severity of symptoms and functional impact.