OBJECTIVE: To investigate capillary blood flow in the optic nerve head (ONH) of children with cerebral malaria. METHODS: Malawian children with cerebral malaria admitted to a paediatric research ward were examined by direct and indirect ophthalmoscopy. ONH blood flow was measured using laser Doppler flowmetry (LDF) in suitable patients. Mean blood volume and velocity were obtained from 30 to 60 s recordings from the temporal ONH and used to calculate blood flow. These were compared with admission variables, funduscopic findings and disease outcomes. RESULTS: 45 children with cerebral malaria had LDF recordings; 6 subsequently died and 5 survivors had neurological sequelae. 12 (27%) had papilloedema. The mean microvascular blood volume was higher in patients with papilloedema (3.28 v 2.54 arbitrary units, p = 0.002). The blood velocity correlated directly with haematocrit (r = 0.46, p = 0.001) and inversely with blood glucose (r = -0.49, p = 0.001). CONCLUSION: The increase in ONH microvascular blood volume in papilloedema measured by LDF is consistent with current theories of pathogenesis of papilloedema. LDF has potential as a tool to distinguish papilloedema from pseudopapilloedematous disc swellings. The relationship between blood velocity and haematocrit may relate to levels of sequestration in cerebral malaria.
OBJECTIVE: To investigate capillary blood flow in the optic nerve head (ONH) of children with cerebral malaria. METHODS: Malawian children with cerebral malaria admitted to a paediatric research ward were examined by direct and indirect ophthalmoscopy. ONH blood flow was measured using laser Doppler flowmetry (LDF) in suitable patients. Mean blood volume and velocity were obtained from 30 to 60 s recordings from the temporal ONH and used to calculate blood flow. These were compared with admission variables, funduscopic findings and disease outcomes. RESULTS: 45 children with cerebral malaria had LDF recordings; 6 subsequently died and 5 survivors had neurological sequelae. 12 (27%) had papilloedema. The mean microvascular blood volume was higher in patients with papilloedema (3.28 v 2.54 arbitrary units, p = 0.002). The blood velocity correlated directly with haematocrit (r = 0.46, p = 0.001) and inversely with blood glucose (r = -0.49, p = 0.001). CONCLUSION: The increase in ONH microvascular blood volume in papilloedema measured by LDF is consistent with current theories of pathogenesis of papilloedema. LDF has potential as a tool to distinguish papilloedema from pseudopapilloedematous disc swellings. The relationship between blood velocity and haematocrit may relate to levels of sequestration in cerebral malaria.
Authors: K Silamut; N H Phu; C Whitty; G D Turner; K Louwrier; N T Mai; J A Simpson; T T Hien; N J White Journal: Am J Pathol Date: 1999-08 Impact factor: 4.307
Authors: Nicholas A V Beare; Terrie E Taylor; Simon P Harding; Susan Lewallen; Malcolm E Molyneux Journal: Am J Trop Med Hyg Date: 2006-11 Impact factor: 2.345
Authors: Armand Movaffaghy; Jonathan Lochhead; Charles E Riva; Simon P Harding; Benno L Petrig; Malcom E Molyneux; Terry E Taylor Journal: Microvasc Res Date: 2002-09 Impact factor: 3.514
Authors: Nicholas A Beare; Caroline Southern; Chipo Chalira; Terrie E Taylor; Malcolm E Molyneux; Simon P Harding Journal: Arch Ophthalmol Date: 2004-08
Authors: Terrie E Taylor; Wenjiang J Fu; Richard A Carr; Richard O Whitten; Jeffrey S Mueller; Nedson G Fosiko; Susan Lewallen; N George Liomba; Malcolm E Molyneux; Jeffrey G Mueller Journal: Nat Med Date: 2004-01-25 Impact factor: 53.440
Authors: Mahalia S Desruisseaux; Fabiana S Machado; Louis M Weiss; Herbert B Tanowitz; Linnie M Golightly Journal: Am J Pathol Date: 2010-01-21 Impact factor: 4.307
Authors: Minxian Dai; Sandra E Reznik; David C Spray; Louis M Weiss; Herbert B Tanowitz; Maria Gulinello; Mahalia S Desruisseaux Journal: Microbes Infect Date: 2010-08-26 Impact factor: 2.700
Authors: Vera A Essuman; Christine T Ntim-Amponsah; Birgitte S Astrup; George O Adjei; Jorgen A L Kurtzhals; Thomas A Ndanu; Bamenla Goka Journal: Malar J Date: 2010-08-12 Impact factor: 2.979
Authors: Minxian Dai; Brandi Freeman; Henry J Shikani; Fernando Pereira Bruno; J Elias Collado; Rolando Macias; Sandra E Reznik; Peter Davies; David Conover Spray; Herbert Bernard Tanowitz; Louis Martin Weiss; Mahalia Sabrina Desruisseaux Journal: PLoS One Date: 2012-10-17 Impact factor: 3.240