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.
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.
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.
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.
Richard James Maude, BUM Wahid Ahmed, Abu Hayat Md Waliur Rahman, Ridwanur Rahman, Mohammed Ishaque Majumder, Darryl Braganza Menezes, Abdullah Abu Sayeed, Laura Hughes, Thomas J MacGillivray, Shyamanga Borooah, Baljean Dhillon, Arjen M Dondorp, Mohammad Abul Faiz. (2014). Retinal changes in visceral leishmaniasis by retinal photography. BMC Infectious Diseases, 14(1)