Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Hyperreflective spots in cerebral malaria

Eye volume 37, page 3295 (2023)Cite this article

Subjects

A Correction to this article was published on 03 July 2023

This article has been updated

We read with interest the article “Optical coherence tomography as retinal imaging biomarker of neuroinflammation/neurodegeneration in systemic disorders in adults and children”, recently published in print [1]. In particular, the authors nicely summarised the hypotheses with respect to the aetiology of hyperreflective spots (HRS) in the retina. Of all the paediatric neuroinflammatory/neurodegenerative disorders listed by the authors in Table 2, malaria has the highest global child morbidity and mortality with 400,000 deaths per year.

The aetiology of HRS in CM remains to be fully elucidated. HRS in CM localise to the superficial, intermediate and deep capillary plexuses, and do not appear to affect the outer retina, but their characteristics are otherwise as described by Vujosevic et al. Evidence of sequestration in the retinal microvasculature from autopsy samples of fatal cases supports the hypothesis that HRS are related to parasite sequestration. This theory is strengthened by work in a mouse model, which co-localised HRS on OCT to areas of parasite sequestration using fundus imaging with labelled parasites and histological sections [4].

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Optical coherence tomography image of the right eye of a 5-year-old with cerebral malaria.

Change history

References

  1. Vujosevic S, Parra MM, Hartnett ME, O’Toole L, Nuzzi A, Limoli C, et al. Optical coherence tomography as retinal imaging biomarker of neuroinflammation/neurodegeneration in systemic disorders in adults and children. Eye. 2023;37:203–19.

    Article  PubMed  Google Scholar 

  2. Taylor TE, Fu WJ, Carr RA, Whitten RO, Mueller JG, Fosiko NG, et al. Differentiating the pathologies of cerebral malaria by postmortem parasite counts. Nat Med. 2004;10:143–5.

    Article  CAS  PubMed  Google Scholar 

  3. Tu Z, Gormley J, Sheth V, Seydel KB, Taylor T, Beare N, et al. Cerebral malaria: insight into pathology from optical coherence tomography. Sci Rep. 2021;11:15722.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Paquet-Durand F, Beck SC, Das S, Huber G, Chang L, Schubert T, et al. A retinal model of cerebral malaria. Sci Rep. 2019;9:3470.

    Article  PubMed  PubMed Central  Google Scholar 

  5. MacCormick IJC, Beare NAV, Taylor TE, Barrera V, White VA, Hiscott P, et al. Cerebral malaria in children: using the retina to study the brain. Brain J Neurol. 2014;137:2119–42.

    Article  Google Scholar 

Download references

Funding

Wellcome Trust Investigator Award in Science: Predicting acute and post-recovery outcomes in cerebral malaria and other comas by optical coherence tomography. Grant Number: 222530/Z/21/Z.

Author information

Authors and Affiliations

  1. Department of Eye & Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, William Henry Duncan Building, 6 West Derby Street, Liverpool, L69 7TX, UK

    Kyle J. Wilson & Nicholas A. V. Beare

  2. Clinical and Laboratory Malaria, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi

    Kyle J. Wilson

  3. St. Paul’s Eye Unit, Royal Liverpool University Hospital, West Derby Street, Liverpool, L7 8YA, UK

    Nicholas A. V. Beare

Authors
  1. Kyle J. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicholas A. V. Beare
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Concept, draft and online submission: KJW. Final draft and accuracy check: KJW, NAVB.

Corresponding author

Correspondence to Kyle J. Wilson.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this article was revised: the affiliations for the author Nicholas A. V. Beare have been corrected from 2, 3 to 1, 3.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilson, K.J., Beare, N.A.V. Hyperreflective spots in cerebral malaria. Eye 37, 3295 (2023). https://doi.org/10.1038/s41433-023-02485-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-023-02485-0

Search

Advanced search

Quick links