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The Fundus in Severe Malaria
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I would like to congratulate Hero et al1 on their excellent photographic documentation of some of the fundus findings in cerebral malaria in their recent publication titled "Photographic and Angiographic Characterization of the Retina of Kenyan Children With Severe Malaria."1 Hemorrhages and white-centered hemorrhages have been described and photographed before, but this publication is the first photographic documentation of the retinal whitening and the unusual appearance of retinal vessels in children with cerebral malaria. I would like to make several points about these phenomena. I must disagree with the authors' suggestion that the whitening is in the inner retina; as their photographs show, the vessels can be seen overlying the whitening and are not obscured by it, making it difficult to imagine how the whitening could be in the inner layers of the retina. When the phenomenon occurs in the macula, and especially when it is severe in the macula, . . . [Full Text of this Article]
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