Retinal imaging technologies in cerebral malaria: a systematic review

Abstract Background Cerebral malaria (CM) continues to present a major health challenge, particularly in sub-Saharan Africa. CM is associated with a characteristic malarial retinopathy (MR) with diagnostic and prognostic significance. Advances in retinal imaging have allowed researchers to better ch...

Full description

Bibliographic Details
Published in:Malaria Journal
Main Authors: Kyle J. Wilson, Amit Dhalla, Yanda Meng, Zhanhan Tu, Yalin Zheng, Priscilla Mhango, Karl B. Seydel, Nicholas A. V. Beare
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2023
Subjects:
Online Access:https://doi.org/10.1186/s12936-023-04566-7
https://doaj.org/article/3e1c51cd8f024735b9e39ded5d91cff5
Description
Summary:Abstract Background Cerebral malaria (CM) continues to present a major health challenge, particularly in sub-Saharan Africa. CM is associated with a characteristic malarial retinopathy (MR) with diagnostic and prognostic significance. Advances in retinal imaging have allowed researchers to better characterize the changes seen in MR and to make inferences about the pathophysiology of the disease. The study aimed to explore the role of retinal imaging in diagnosis and prognostication in CM; establish insights into pathophysiology of CM from retinal imaging; establish future research directions. Methods The literature was systematically reviewed using the African Index Medicus, MEDLINE, Scopus and Web of Science databases. A total of 35 full texts were included in the final analysis. The descriptive nature of the included studies and heterogeneity precluded meta-analysis. Results Available research clearly shows retinal imaging is useful both as a clinical tool for the assessment of CM and as a scientific instrument to aid the understanding of the condition. Modalities which can be performed at the bedside, such as fundus photography and optical coherence tomography, are best positioned to take advantage of artificial intelligence-assisted image analysis, unlocking the clinical potential of retinal imaging for real-time diagnosis in low-resource environments where extensively trained clinicians may be few in number, and for guiding adjunctive therapies as they develop. Conclusions Further research into retinal imaging technologies in CM is justified. In particular, co-ordinated interdisciplinary work shows promise in unpicking the pathophysiology of a complex disease.