title: Retinal changes in visceral leishmaniasis by retinal photography.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. richardmaude@gmail.com.
authors.forename: Richard James
authors.initials: RJ
authors.lastname: Maude
authors.forename: B U M Wahid
authors.initials: BU
authors.lastname: Ahmed
authors.forename: Abu Hayat Md Waliur
authors.initials: AH
authors.lastname: Rahman
authors.forename: Ridwanur
authors.initials: R
authors.lastname: Rahman
authors.forename: Mohammed Ishaque
authors.initials: MI
authors.lastname: Majumder
authors.forename: Darryl Braganza
authors.initials: DB
authors.lastname: Menezes
authors.forename: Abdullah
authors.initials: A
authors.lastname: Abu Sayeed
authors.forename: Laura
authors.initials: L
authors.lastname: Hughes
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: MacGillivray
authors.forename: Shyamanga
authors.initials: S
authors.lastname: Borooah
authors.forename: Baljean
authors.initials: B
authors.lastname: Dhillon
authors.forename: Arjen M
authors.initials: AM
authors.lastname: Dondorp
authors.forename: Mohammad Abul
authors.initials: MA
authors.lastname: Faiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001459:Bangladesh; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D008297:Male; D010781:Photography; D011446:Prospective Studies; D012160:Retina / Q000469:parasitology* / Q000473:pathology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000469:parasitology; D055815:Young Adult