title: Bilateral subhyaloid haemorrhage in a conscious patient: a new spectrum of ocular involvement by Plasmodium falciparum.
abstract: A 24-year-old woman presented with a history of high-grade fever with rigours since 3 days and bilateral sudden loss of vision since 6 h. She was conscious, oriented and her vitals were stable. She had a temperature of 101°F, anaemia, thrombocytopaenia, normal white cell count and moderate splenomegaly. On testing visual activity, she could only perceive hand movements although her pupils were bilaterally equal, and normal in size and reaction. On indirect ophthalmoscopy, optic discs were normal bilaterally; however, fovea of both eyes was masked by subhyaloid haemorrhage. Peripheral smear showed gametocytes of Plasmodium falciparum. The patient was started on arteminsinin-combined therapy and advised to be in propped-up position to help resolution of the haemorrhage. The patient was afebrile in 4 days and follow-up fundus examination showed gradual resolution of the haemorrhage. After two months, the patient regained normal visual acuity in both eyes; however, it took nearly 3 months for complete resolution of the haemorrhage.
authors.affiliation: Department of Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.
authors.forename: Nasar
authors.initials: N
authors.lastname: Abdali
authors.affiliation: Department of Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.
authors.forename: Azharuddin Mohammed
authors.initials: AM
authors.lastname: Malik
authors.affiliation: Department of Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.
authors.forename: Md Dilawez
authors.initials: MD
authors.lastname: Shamim
authors.affiliation: Department of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.
authors.forename: Syed Wajahat Ali
authors.initials: SW
authors.lastname: Rizvi
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D037621:Artemisinins / Q000627:therapeutic use; D000077332:Artesunate; D005130:Eye Hemorrhage / Q000209:etiology* / Q000628:therapy; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy; D015767:Mefloquine / Q000627:therapeutic use; D056888:Patient Positioning; D010963:Plasmodium falciparum; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D015767:Mefloquine