An unusual macular lesion associated with malaria

A case of a young man afflicted with falciparum malaria is presented in which the primary ocular finding was a subpigment epithelial hemorrhage involving the macula. Previous reports in the literature concentrate on peripheral and central retinal hemorrhages, almost to the exclusion of choroidal vascular abnormalities. The value of this case lies in the recognition that the choroid can assume an important role in fundus abnormalities associated with malaria, probably on the basis of obstructive phenomena with subsequent ischemic degenerative changes, similar to the process which involves the retinal vessels and central nervous system.