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Cerebral malaria: insight into pathology from optical coherence tomography
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-ye...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8333417/ https://www.ncbi.nlm.nih.gov/pubmed/34344903 http://dx.doi.org/10.1038/s41598-021-94495-9 |
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author | Tu, Zhanhan Gormley, Jack Sheth, Viral Seydel, Karl B. Taylor, Terrie Beare, Nicholas Barrera, Valentina Proudlock, Frank A. Manda, Chatonda Harding, Simon Gottlob, Irene |
author_facet | Tu, Zhanhan Gormley, Jack Sheth, Viral Seydel, Karl B. Taylor, Terrie Beare, Nicholas Barrera, Valentina Proudlock, Frank A. Manda, Chatonda Harding, Simon Gottlob, Irene |
author_sort | Tu, Zhanhan |
collection | PubMed |
description | 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 (p = 0.027) which was more pronounced after 1 year (p = 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. |
format | Online Article Text |
id | pubmed-8333417 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-83334172021-08-05 Cerebral malaria: insight into pathology from optical coherence tomography Tu, Zhanhan Gormley, Jack Sheth, Viral Seydel, Karl B. Taylor, Terrie Beare, Nicholas Barrera, Valentina Proudlock, Frank A. Manda, Chatonda Harding, Simon Gottlob, Irene Sci Rep Article 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 (p = 0.027) which was more pronounced after 1 year (p = 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. Nature Publishing Group UK 2021-08-03 /pmc/articles/PMC8333417/ /pubmed/34344903 http://dx.doi.org/10.1038/s41598-021-94495-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Tu, Zhanhan Gormley, Jack Sheth, Viral Seydel, Karl B. Taylor, Terrie Beare, Nicholas Barrera, Valentina Proudlock, Frank A. Manda, Chatonda Harding, Simon Gottlob, Irene Cerebral malaria: insight into pathology from optical coherence tomography |
title | Cerebral malaria: insight into pathology from optical coherence tomography |
title_full | Cerebral malaria: insight into pathology from optical coherence tomography |
title_fullStr | Cerebral malaria: insight into pathology from optical coherence tomography |
title_full_unstemmed | Cerebral malaria: insight into pathology from optical coherence tomography |
title_short | Cerebral malaria: insight into pathology from optical coherence tomography |
title_sort | cerebral malaria: insight into pathology from optical coherence tomography |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8333417/ https://www.ncbi.nlm.nih.gov/pubmed/34344903 http://dx.doi.org/10.1038/s41598-021-94495-9 |
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