A review of malarial retinopathy in severe malaria

Abstract

The ocular manifestations of severe malaria in patients with cerebral malaria (CM) include retinal whitening, vessel discolouration, retinal haemorrhages and papilloedema. A large prospective study of Malawian children with CM found that the severity of retinal signs, including the number of retinal haemorrhages, was related to the outcome and length of coma in survivors of malaria. In a smaller number of Kenyan children with cerebral malaria, retinal haemorrhages were associated with deep coma and severe anaemia. A study on the effect of malarial retinopathy on vision found no detectable effect on visual acuity (VA) but where malaria is aggravated by failure to receive treatment this may possibly affect VA. The failure to receive treatment may be directly linked to the socio-economic status (SES) of those affected and this may occur in the KwaZulu-Natal, Mpumalanga and Limpopo provinces of South Africa where malaria is endemic. This suggests the need for effective health education and health promotion amongst those affected by malaria especially in severely affected provinces of South Africa. Also, in view of the direct ocular consequences of severe malaria, optometrists should engage communities in health education and health promotion. This is particularly relevant because in some communities, a large majority of those suffering from malarial infections do not visit formal health facilities for treatment. In so doing, optometrists in South Africa will be contributing positively to the Millennium Development Goals which seek, amongst others, to reduce unwarranted sources of morbidity worldwide. (S Afr Optom 2011 70(3) [129][130][131][132][133][134][135]

To report a case of unilateral proliferative retinopathy following noncerebral malaria with Plasmodium falciparum in Southern India

“…[ 4 ] The retinopathy seen in association with severe malaria is well-described in African sub-continent. [ 1 5 ] P. falciparum has been found to be associated with retinopathy in malaria in almost all the cases. [ 6 ] Actually the term malaria retinopathy has been used in association with severe malaria caused by P. falciparum .…”

“…Malaria retinopathy has been used to denote the fundus changes seen in patients with malaria caused by Plasmodium falciparum . [ 1 ] Seen mainly in the patients with cerebral malaria (CM), these changes correlate well with the patho-physiology of obstruction of the microvasculature with infected erythrocytes. Patchy retinal whitening and focal changes in the vessel wall coloration are the most characteristic changes.…”

Automatic Detection and Classification of Malarial Retinopathy- Associated Retinal Whitening in Digital Retinal Images

“…Early detection of these retinal abnormalities can lead to the detection of cerebral malaria. Cerebral Malaria remains the biggest killer amongst all forms of parasitic malaria, especially in tropical and equatorial regions of the globe [1]. Retinal whitening is characterised as macular whitening or peripheral whitening.…”

“…Retinal whitening in fundus images is one of the most distinct signs of cerebral malaria [1]. Unlike vascular haemorrhages and Papilledema, retinal whitening manifests itself as a unique sign of cerebral malaria.…”

“…Most of the researchers have developed computerized methods and models for this purpose using fundus images. Retinal whitening is a very distinct sign for cerebral malaria and has been discussed in literature [1] for clinical diagnosis of the disease. However, retinal whitening has not been used in any of these models as a detection and classification parameter.…”