Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria

  title={Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria},
  author={Vinayak S. Joshi and Carla Agurto and Simon Barriga and Sheila Coyne Nemeth and Peter Soliz and Ian J. C. MacCormick and Susan Lewallen and Terrie E. Taylor and Simon Peter Harding},
  journal={Scientific Reports},
Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system… 
Automated Detection of Malarial Retinopathy in Retinal Fundus Images obtained in Clinical Settings
  • V. Joshi, J. Wigdahl, P. Soliz
  • Medicine
    2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)
  • 2018
An automated software system that detects the retinal lesions specific to MR, whitening and hemorrhages, using retinal color fundus images demonstrates potential for broad screening of MR and can be integrated with a low-cost and portable retinal camera, to provide a bed-side tool for confirming CM diagnosis.
Automated Detection of Malarial Retinopathy Using Transfer Learning
A technique based on a transfer learning technique using images from three different retinal cameras to identify the hemorrhages and whitening lesions in the retina which can accurately identify the patients with MR is demonstrated.
AI-Based Method for Detecting Retinal Haemorrhage in Eyes with Malarial Retinopathy
A deep learning-based haemorrhages detection of MR inspired by Dense-Net based network called one-hundred-layers tiramisu for the segmentation tasks is introduced and shows that the proposed method outperforms commonly mainstream network architecture U-Net.
Neurovascular sequestration in paediatric P. falciparum malaria is visible clinically in the retina
Retinal vessel changes and retinal whitening, distinctive features of malarial retinopathy, can be directly observed during routine eye examination in children with P. falciparum cerebral malaria, and are a marker of severe disease useful for diagnosis and management.
Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria
Evidence is found that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM, and a lower bound for the fraction of retInopathy- negative CM that would be prevented if malaria Parasitemia were to be eliminated is estimated to be 0.93.
Retinopathy-Positive Cerebral Malaria Is Associated With Greater Inflammation, Blood-Brain Barrier Breakdown, and Neuronal Damage Than Retinopathy-Negative Cerebral Malaria.
RN CM may be driven by early vasospasm and platelet activation, whereas the more advanced RP CM is associated with greater inflammation, increased erythropoietic drive, blood-brain barrier breakdown, and neuronal injury, each of which may contribute to greater disease severity.
Pediatric Cerebral Malaria
Recent updates in research into cerebral malaria pathogenesis, clinical care, treatment, and prevention are reviewed, including design and testing of candidate vaccines.
Updates in central nervous system malaria: literature review and considerations
Diagnostic management is based on fast severe malaria identification by blood smear (thin and thick), however, newer techniques involving molecular testing (such as PCR or LAMP) and biomarkers identification are now available and it is also important to check patients' cerebral functions.
Modelling and time evaluation of optical disc and retinal lesions
The proposed methodology for a time modelling of the retinal lesions comprises three essential procedures and the binary classification is used with a target of an extraction of a respective model of the optical disc and theretinal lesions.


Automated detection of malarial retinopathy-associated retinal hemorrhages.
PURPOSE To develop an automated method for the detection of retinal hemorrhages on color fundus images to characterize malarial retinopathy, which may help in the assessment of patients with cerebral
Malarial retinopathy: a newly established diagnostic sign in severe malaria.
Current knowledge of malarial retinopathy is reviewed, including its use as a diagnostic test in the comatose child, and its value as a tool for research into the pathophysiology of cerebral malaria are reviewed.
Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria
Retinal whitening, a sign suggestive of retinal ischaemia, was significantly more common in CM than in non-CM syndromes, however, the high prevalence of any retinopathy in the latter suggests that the brain and the retina may be suffering from ischaemic in both CM and non- CM.
Redefining cerebral malaria by including malaria retinopathy.
In view of its important contributions to both clinical care and research, examination of the retina should become a routine component of the assessment of a comatose child or adult when CM is a possible diagnosis.
Perfusion abnormalities in children with cerebral malaria and malarial retinopathy.
Impaired perfusion occurs in the retinal microvasculature of most children with cerebral malaria, evidence for hypoxia and ischemia as important components in the pathogenesis of CM.
Comparison of the effectiveness of three retinal camera technologies for malarial retinopathy detection in Malawi
The study found that the mid-priced Pictor Plus hand-held camera performed considerably better than the lower price mobile phone-based camera, and slightly the higher priced table top camera.
Identification of malaria retinopathy improves the specificity of the clinical diagnosis of cerebral malaria: findings from a prospective cohort study.
Findings from an autopsy-based study suggest that identifying malaria retinopathy in children satisfying the standard clinical case definition of CM improves the ability to accurately diagnose CM in vivo.
Retinal Pathology of Pediatric Cerebral Malaria in Malawi
The histopathological findings of eyes of patients who died and underwent autopsy offer insights into the etiology of malarial retinopathy and provide a pathological basis for recently described retinal capillary non-perfusion in children with malarial Retinopathy.
Severity of Retinopathy Parallels the Degree of Parasite Sequestration in the Eyes and Brains of Malawian Children With Fatal Cerebral Malaria
Background. Malarial retinopathy (MR) has diagnostic and prognostic value in children with Plasmodium falciparum cerebral malaria (CM). A clinicopathological correlation between observed retinal