Diagnosing Cerebral Malaria through Retina

Q: Which of the following retinal features is specific of cerebral malaria and can actually be diagnostic? 

 A) blurred disc margins 
 B) papilloedema 
 C) retinal hemorrhages 
 D) retinal whitening 
 E) retinal edema


Answer: D


 Retina provides a unique opportunity to observe clues to the diagnosis of cerebral malaria. In fact, the detection of malarial retinopathy can be diagnostic for cerebral malaria, as set of retinal abnormalities are unique to cerebral malaria. These abnormalities include blurred disc margins, papilloedema, retinal hemorrhages, retinal whitening, retinal edema, vascular changes and soft exudates. Of these retinal whitening and vascular changes are specific to cerebral malaria.

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References:

1. Pedrosa CA, Santos C, Coutinho I, et al. Ophthalmologic identification of cerebral malaria in adults. GMS Ophthalmol Cases. 2015;5:Doc13. Published 2015 Nov 2.

2. Beare NA, Lewallen S, Taylor TE, Molyneux ME. Redefining cerebral malaria by including malaria retinopathy. Future Microbiol. 2011 Mar;6(3):349–355.

3. Maude RJ, Dondorp AM, Abu Sayeed A, Day NP, White NJ, Beare NA. The eye in cerebral malaria: what can it teach us? Trans R Soc Trop Med Hyg. 2009 Jul;103(7):661–664.