OCULAR MALARIA - A CLINICAL AND HISTOPATHOLOGIC STUDY

Purpose: Clinical and histopathologic findings of ocular lesions in ma laria rarely have been described. This study reports lesions in three patients with malaria, with a histopathologic study of eyes obtained a t autopsy of one of these patients. Methods: Various ocular lesions we re documented in three patients with malarial infection, with histopat hologic study of one patient. in all three patients, the diagnosis of malaria was confirmed by the demonstration of malarial parasites in pe ripheral smears and by fluorescent microscopy of acridine orange-stain ed buffy coat preparations of venous blood, Results: Multiple superfic ial blotchy retinal hemorrhages over the posterior pole were seen in t he first patient, whereas acute bilateral panuveitis and secondary gla ucoma were seen in the second, which on resolution showed multiple blo tchy superficial retinal hemorrhages with perivasculitis, The third pa tient had cerebral malaria and was found to have subconjunctival and r etinal hemorrhages. This patient died of pulmonary thromboembolism, an d the eyes were obtained at autopsy. On gross examination, there were multiple retinal hemorrhages in the posterior pole, Histopathologic st udy showed cytoadherence of parasitized erythrocytes as well as schizo nts and gametocytes of Plasmodium vivax within the retinal and choroid al blood vessels. Conclusion: The authors' findings suggest that patie nts with unexplained blotchy retinal hemorrhages should be investigate d for malarial infection, especially if they reside or have travelled in endemic areas.