# Type II Acute Macular Neuroretinopathy Secondary to Malaria

## TL;DR

This paper reports the first case of type II acute macular neuroretinopathy linked to malaria, highlighting new imaging findings in retinal damage.

## Contribution

The first documented case of type II AMN associated with malarial retinopathy and cerebral malaria.

## Key findings

- Bilateral retinal hemorrhages and foveal pigmentary changes were observed in malarial retinopathy.
- OCT and OCT-A revealed hyperreflective changes and flow voids in the outer retinal layers.
- The case introduces a potential imaging biomarker for assessing retinal ischaemia in malaria.

## Abstract

To the best of our knowledge, we present the first case of type II acute macular neuroretinopathy (AMN) exhibiting in a patient suffering from malarial retinopathy concomitant with cerebral malaria acquired after travelling to West Africa without taking the necessary antimalarial prophylaxis. The patient complained of bilateral blurring of vision after being removed off sedation whilst at the intensive care unit. Subsequent examination revealed bilateral retinal haemorrhages, cotton-wool spots, and foveal pigmentary changes in keeping malarial retinopathy. Macular optical coherence tomography (OCT) revealed patchy hyperreflective changes at the level of the outer plexiform and outer nuclear layers (ONL) in keeping with the areas of deep capillary plexus flow void noted on OCT-angiography (OCT-A). This case report sheds more light on the extent of neurosensory retinal ischaemia in malarial retinopathy and showcases a new imaging biomarker which may be utilized in assessing and quantifying the functional deficit created by this disease.