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dc.contributor.authorMacCormick, Ian J. C.
dc.contributor.authorMaude, Richard J.
dc.contributor.authorBeare, Nicholas A. V.
dc.contributor.authorBorooah, Shyamanga
dc.contributor.authorGlover, Simon James
dc.contributor.authorParry, David
dc.contributor.authorLeach, Sophie
dc.contributor.authorMolyneux, Malcolm E.
dc.contributor.authorDhillon, Baljean
dc.contributor.authorLewallen, Susan
dc.contributor.authorHarding, Simon P.
dc.identifier.citationMacCormick , I J C , Maude , R J , Beare , N A V , Borooah , S , Glover , S J , Parry , D , Leach , S , Molyneux , M E , Dhillon , B , Lewallen , S & Harding , S P 2015 , ' Grading fluorescein angiograms in malarial retinopathy ' , Malaria Journal , vol. 14 , 367 .
dc.descriptionThis work was funded by The Wellcome Trust (IJCM, SPH, NAVB, MEM, DP, SoL: Grant No. 092668/Z/10/Z; Core Grant No. 084679/Z/08/Z).en
dc.description.abstractBackground: Malarial retinopathy is an important finding in Plasmodium falciparum cerebral malaria, since it strengthens diagnostic accuracy, predicts clinical outcome and appears to parallel cerebral disease processes. Several angiographic features of malarial retinopathy have been described, but observations in different populations can only be reliably compared if consistent methodology is used to capture and grade retinal images. Currently no grading scheme exists for fluorescein angiographic features of malarial retinopathy. Methods: A grading scheme for fluorescein angiographic images was devised based on consensus opinion of clinicians and researchers experienced in malarial retinopathy in children and adults. Dual grading were performed with adjudication of admission fluorescein images from a large cohort of children with cerebral malaria. Results: A grading scheme is described and standard images are provided to facilitate future grading studies. Inter-grader agreement was >70 % for most variables. Intravascular filling defects are difficult to grade and tended to have lower inter-grader agreement (>57 %) compared to other features. Conclusions: This grading scheme provides a consistent way to describe retinal vascular damage in paediatric cerebral malaria, and can facilitate comparisons of angiographic features of malarial retinopathy between different patient groups, and analysis against clinical outcomes. Inter-grader agreement is reasonable for the majority of angiographic signs. Dual grading with expert adjudication should be used to maximize accuracy.
dc.relation.ispartofMalaria Journalen
dc.subjectSevere malariaen
dc.subjectMalarial retinopathyen
dc.subjectFluorescein angiographyen
dc.subjectInter-grader agreementen
dc.subjectCerebral malariaen
dc.subjectR Medicine (General)en
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleGrading fluorescein angiograms in malarial retinopathyen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.description.statusPeer revieweden

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