The effect of quinine on the electroretinograms of children with pediatric cerebral malaria.
To investigate the effects of quinine on the electroretinograms (ERGs) of children with cerebral malaria (CM), we recruited subjects during a single malaria season in Blantyre, Malawi. Seventy ERG investigations were performed, on 34 children with CM. Time recorded from completion of the most recent quinine infusion was termed "quinine elapsed time" (QET). In a subgroup of 16 children, whole-blood quinine concentrations were estimated in a sample of capillary blood, for validation. A significant positive association was found between QET and both maximal-response A-wave amplitude (MRAWA; P=.03) and cone A-wave amplitude (P=.04). Longitudinal analysis demonstrated a significant trend of increasing MRAWA with increasing QET (P=.03). Parenteral quinine administered in therapeutic doses to a pediatric population appears to cause a transient depression in photoreceptor function. No evidence of ocular quinine toxicity was found at the therapeutic doses used.
Lochhead
Jonathan
J
St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. jonlochh@AOL.com
Movaffaghy
Armand
A
Falsini
Benedetto
B
Winstanley
Peter A
PA
Mberu
Edward K
EK
Riva
Charles E
CE
Molyneux
Malcolm E
ME
Taylor
Terrie E
TE
Harding
Simon P
SP
D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D004596:Electroretinography; D005260:Female; D006801:Humans; D016014:Linear Models; D016779:Malaria, Cerebral / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011803:Quinine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D012160:Retina / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology*; D012164:Retinal Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors
D000962:Antimalarials; D011803:Quinine