Tu, Zhanhan, Gormley, Jack, Sheth, Viral, Seydel, Karl B, Taylor, Terrie, Beare, Nicholas 
ORCID: 0000-0001-8086-990X, Barrera, Valentina, Proudlock, Frank A, Manda, Chatonda, Harding, Simon ORCID: 0000-0003-4676-1158 et al (show 1 more authors)
(2021)
Cerebral malaria: insight into pathology from optical coherence tomography.
Scientific Reports, 11 (1).
15722-.
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Tu et al. SciRep 2021.pdf - Published version Download (3MB) | Preview |
Abstract
<jats:title>Abstract</jats:title><jats:p>We aimed to investigate structural retinal changes in malarial retinopathy (MR) using hand-held optical coherence tomography (HH-OCT) to assess its diagnostic potential. Children with MR (n = 43) underwent ophthalmoscopy, fluorescein angiography and HH-OCT during admission, 1-month (n = 31) and 1-year (n = 8) post-discharge. Controls were comatose patients without malaria (n = 6) and age/sex-matched healthy children (n = 43). OCT changes and retinal layer thicknesses were compared. On HH-OCT, hyper-reflective areas (HRAs) were seen in the inner retina of 81% of MR patients, corresponding to ischaemic retinal whitening on fundus photography. Cotton wool spots were present in 37% and abnormal hyper-reflective dots, co-localized to capillary plexus, in 93%. Hyper-reflective vessel walls were present in 84%, and intra-retinal cysts in 9%. Vascular changes and cysts resolved within 48 h. HRAs developed into retinal thinning at 1 month (<jats:italic>p</jats:italic> = 0.027) which was more pronounced after 1 year (<jats:italic>p</jats:italic> = 0.009). Ischaemic retinal whitening is located within inner retinal layers, distinguishing it from cotton wool spots. Vascular hyper-reflectivity may represent the sequestration of parasitized erythrocytes in vessels, a key CM feature. The mechanisms of post-ischemic retinal atrophy and cerebral atrophy with cognitive impairment may be similar in CM survivors. HH-OCT has the potential for monitoring patients, treatment response and predicting neurological deficits.</jats:p>
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Retinal Vessels, Retina, Humans, Malaria, Cerebral, Malaria, Falciparum, Retinal Diseases, Tomography, Optical Coherence, Fluorescein Angiography, Diagnostic Techniques, Ophthalmological, Ophthalmoscopy, Aftercare, Child, Child, Preschool, Infant, Female, Male |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 13 Aug 2021 09:25 |
| Last Modified: | 18 Jan 2023 21:33 |
| DOI: | 10.1038/s41598-021-94495-9 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3133359 |
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