Lewallen S, Bakker H, Taylor T E, Wills B A, Courtright P, Molyneux M E
International Eye Foundation, Blantyre, Malawi.
Trans R Soc Trop Med Hyg. 1996 Mar-Apr;90(2):144-6. doi: 10.1016/s0035-9203(96)90116-9.
The pathogenesis of cerebral malaria is poorly understood. Direct and indirect ophthalmoscope examinations of 141 Malawian children with strictly defined cerebral malaria revealed 2 distinct and prognostically significant findings: papilloedema and extramacular retinal oedema. The relative risk of death in patients with papilloedema was 6.7 times that in patients without papilloedema. Extramacular retinal oedema was associated with a 2.9 fold increase in the relative risk of dying. The mortality rate in patients with neither of these signs was only 1.3% compared to an overall mortality rate of 9.2%. The clinical and laboratory features associated with each of these ophthalmological findings were different, suggesting that there may be at least 2 different pathogenetic processes in patients with cerebral malaria.
脑型疟疾的发病机制尚不清楚。对141名严格定义为脑型疟疾的马拉维儿童进行直接和间接检眼镜检查，发现了2个不同且具有预后意义的结果：视乳头水肿和黄斑外视网膜水肿。视乳头水肿患者的死亡相对风险是无视乳头水肿患者的6.7倍。黄斑外视网膜水肿使死亡相对风险增加2.9倍。既无这些体征的患者死亡率仅为1.3%，而总体死亡率为9.2%。与这些眼科检查结果相关的临床和实验室特征各不相同，这表明脑型疟疾患者可能至少存在2种不同的发病机制。
