What can we learn from the retina in severe malaria?

Abstract

A characteristic retinopathy can be found by ophthalmoscopy in patients with cerebral malaria (CM). The presence of this retinopathy enhances the confidence with which a diagnosis of CM can be made. Fundoscopy can improve accurate enrollment of cases for studies of malaria pathogenesis or treatment, and can strengthen identification of CM as an endpoint in preventive interventions against malaria. Retinal changes may be instructive about pathological changes that are otherwise unobservable within the brain, and the retina offers the advantage that it can be directly observed during life. With the addition of angiography, retinal studies suggest that CNS microvessels are commonly occluded in CM, and also that the blood-retinal barrier is sometimes breached; an observation that is in keeping with the cerebral edema commonly identified at autopsy in fatal pediatric malaria. © Springer Science+Business Media, LLC 2010.