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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/12098
Title: Malarial retinopathy in Bangladeshi adults
Authors: Abdullah Abu Sayeed
Richard J. Maude
Mahtab Uddin Hasan
Noor Mohammed
M. Gofranul Hoque
Arjen M. Dondorp
M. Abul Faiz
Chittagong Medical College Hospital
Mahidol University
Sir Salimullah Medical College
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-2011
Citation: American Journal of Tropical Medicine and Hygiene. Vol.84, No.1 (2011), 141-147
Abstract: To establish if assessment of malarial retinopathy in adult malaria using ophthalmoscopy by non-ophthalmologists has clinical and prognostic significance, 210 Bangladeshi adults were assessed by both direct and indirect ophthalmoscopy; 20 of 20 healthy subjects and 20 of 20 patients with vivax malaria showed no retinal changes, whereas in patients with falciparum malaria, indirect ophthalmoscopy revealed malarial retinopathy (predominantly retinal hemorrhages) in 18 of 21 (86%) fatal, 31 of 75 (41%) cerebral, 16 of 64 (25%) non-cerebral but severe, and 1 of 31 (3%) uncomplicated cases. Direct ophthalmoscopy missed retinopathy in one of these cases and found fewer retinal hemorrhages (mean difference = 3.09; 95% confidence interval = 1.50-4.68; P < 0.0001). Severity of retinopathy increased with severity of disease (P for trend < 0.0001), and renal failure, acidosis, and moderate/severe retinopathy were independent predictors of mortality by both ophthalmoscopic techniques. Direct ophthalmoscopy by non-ophthalmologists is an important clinical tool to aid diagnosis and prognosis in adults with severe malaria, and indirect ophthalmoscopy by non-ophthalmologists, although more sensitive, provides minimal additional prognostic information. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79952260505&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/12098
ISSN: 00029637
Appears in Collections:Scopus 2011-2015

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