Retina Examination Can Improve Understanding of Cerebral Malaria, Study Says

Examining the retinas of people with cerebral malaria could provide information about how the disease functions and lead to the development of new drugs to combat the disease, according to a study published Thursday in the Journal of Infectious Diseases, Reuters reports (Kahn, Reuters, 1/14). The study demonstrated that malarial retinopathy -- or changes in the retina that accompany cerebral malaria -- can occur when infected blood cells build up in the narrow blood vessels of the brain and prevent the movement of oxygen (IANS/The Hindu, 1/15). According to the researchers, the study demonstrates that drugs to improve circulation, such as statins, could help combat cerebral malaria (Reuters, 1/14).

For the study, Nick Beare of Royal Liverpool University Hospital and colleagues from Queen Elizabeth Central Hospital in Malawi examined the retinas of 34 children diagnosed with cerebral malaria using a technique called flourescein angiography. The technique, which involves injecting dye into the children's arms and photographing its passage through the retina's blood vessels, can identify fluid blockage or leakage in small blood vessels behind the eye. According to the study's findings, the retina examinations revealed impaired blood flow in four-fifths of the children. In addition, three-quarters of the children had whitening in areas of the retina, possibly because malaria parasites had disrupted the flow of oxygen or nutrients and prevented blood from reaching these areas (IANS/The Hindu, 1/15).

According to Beare, the researchers examined eyes for this study because the retina "is really an extension of the brain." Beare said that blockages that prevent the flow of blood and oxygen to the brain are "critical in causing coma and death in cerebral malaria," adding that retina examinations have "opened up our knowledge" about why cerebral malaria is particularly fatal. Although certain drugs, such as Novartis' artemisinin-based combination therapy Coartem, often treat malaria effectively, they are less effective against cerebral malaria because they only target the parasite and not blockages in the brain that can lead to coma and death, Beare said (Reuters, 1/14).

An abstract of the study is available online.