Maude RJ, Ahmed BUMW, Rahman AHMW, Rahman R, Majumder MI, Menezes DB, Abu Sayeed A, Hughes L, MacGillivray TJ, Borooah S, Dhillon B, Dondorp AM, Faiz MA. Retinal changes in visceral leishmaniasis by retinal photography.
BMC Infect Dis 2014;
14:527. [PMID:
25270641 PMCID:
PMC4261886 DOI:
10.1186/1471-2334-14-527]
[Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background
In visceral leishmaniasis (VL), retinal changes have previously been noted but not described in detail and their clinical and pathological significance are unknown. A prospective observational study was undertaken in Mymensingh, Bangladesh aiming to describe in detail visible changes in the retina in unselected patients with VL.
Methods
Patients underwent assessment of visual function, indirect and direct ophthalmoscopy and portable retinal photography. The photographs were assessed by masked observers including assessment for vessel tortuosity using a semi-automated system.
Results
30 patients with VL were enrolled, of whom 6 (20%) had abnormalities. These included 5 with focal retinal whitening, 2 with cotton wool spots, 2 with haemorrhages, as well as increased vessel tortuosity. Visual function was preserved.
Conclusions
These changes suggest a previously unrecognized retinal vasculopathy. An inflammatory aetiology is plausible such as a subclinical retinal vasculitis, possibly with altered local microvascular autoregulation, and warrants further investigation.
Electronic supplementary material
The online version of this article (doi:10.1186/1471-2334-14-527) contains supplementary material, which is available to authorized users.
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