Publication: Grading fluorescein angiograms in malarial retinopathy
Issued Date
2015-12-01
Resource Type
ISSN
14752875
Other identifier(s)
2-s2.0-84942247430
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Malaria Journal. Vol.14, No.1 (2015)
Suggested Citation
Ian J.C. MacCormick, Richard J. Maude, Nicholas A.V. Beare, Shyamanga Borooah, Simon Glover, David Parry, Sophie Leach, Malcolm E. Molyneux, Baljean Dhillon, Susan Lewallen, Simon P. Harding Grading fluorescein angiograms in malarial retinopathy. Malaria Journal. Vol.14, No.1 (2015). doi:10.1186/s12936-015-0897-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36050
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Grading fluorescein angiograms in malarial retinopathy
Other Contributor(s)
University of Liverpool
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
University of Edinburgh
Mahidol University
Nuffield Department of Clinical Medicine
University of Edinburgh, College of Medicine and Veterinary Medicine
Royal Liverpool and Broadgreen University Hospitals NHS Trust
Princess Alexandra Eye Pavilion
University of St Andrews, School of Medicine
Liverpool School of Tropical Medicine
Kilimanjaro Centre for Community Ophthalmology
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
University of Edinburgh
Mahidol University
Nuffield Department of Clinical Medicine
University of Edinburgh, College of Medicine and Veterinary Medicine
Royal Liverpool and Broadgreen University Hospitals NHS Trust
Princess Alexandra Eye Pavilion
University of St Andrews, School of Medicine
Liverpool School of Tropical Medicine
Kilimanjaro Centre for Community Ophthalmology
Abstract
© 2015 MacCormick et al. Background: Malarial retinopathy is an important finding in Plasmodium falciparum cerebral malaria, since it strengthens diagnostic accuracy, predicts clinical outcome and appears to parallel cerebral disease processes. Several angiographic features of malarial retinopathy have been described, but observations in different populations can only be reliably compared if consistent methodology is used to capture and grade retinal images. Currently no grading scheme exists for fluorescein angiographic features of malarial retinopathy. Methods: A grading scheme for fluorescein angiographic images was devised based on consensus opinion of clinicians and researchers experienced in malarial retinopathy in children and adults. Dual grading were performed with adjudication of admission fluorescein images from a large cohort of children with cerebral malaria. Results: A grading scheme is described and standard images are provided to facilitate future grading studies. Inter-grader agreement was >70 % for most variables. Intravascular filling defects are difficult to grade and tended to have lower inter-grader agreement (>57 %) compared to other features. Conclusions: This grading scheme provides a consistent way to describe retinal vascular damage in paediatric cerebral malaria, and can facilitate comparisons of angiographic features of malarial retinopathy between different patient groups, and analysis against clinical outcomes. Inter-grader agreement is reasonable for the majority of angiographic signs. Dual grading with expert adjudication should be used to maximize accuracy.