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Case Reports
. 2011:5:1431-3.
doi: 10.2147/OPTH.S16272. Epub 2011 Oct 4.

Isolated cotton-wool spots of unknown etiology: management and sequential spectral domain optical coherence tomography documentation

Antonis Ioannides  1 , Nikolaos D Georgakarakos, Ibrahim Elaroud, Petros Andreou
Affiliations
Case Reports

Isolated cotton-wool spots of unknown etiology: management and sequential spectral domain optical coherence tomography documentation

Antonis Ioannides et al. Clin Ophthalmol. 2011.

Abstract

Cotton-wool spots (CWSs) are common retinal manifestations of many diseases including diabetes mellitus, systemic hypertension, and acquired immunodeficiency syndrome. Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time. In this study, spectral domain optical coherence tomography (SD-OCT) with mapping was used to demonstrate in vivo the characteristics of an isolated CWS in a 59-year-old patient as well as its appearance immediately after ophthalmoscopic resolution. Presented here is the work-up and management of this clinical problem for the ophthalmologist. The authors propose that SD-OCT could be a valuable research tool in characterizing and following the dynamic CWS changes at individual retinal layer level, with potential clinical applications as a screening or diagnostic tool in CWS-related diseases.

Keywords: SD-OCT; retinal lesion; spectral domain optical coherence tomography.

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Figures

Figure 1
Figure 1
Left fundus photographs: at presentation showing an isolated cotton-wool spot (A); and 9 weeks later showing resolution (B).
Figure 2
Figure 2
Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA) retinal thickness maps: at presentation showing thickening (glowing red) of an area corresponding to the cotton-wool spot (A); and 9 weeks later showing focal thinning (B).
Figure 3
Figure 3
Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA) scans across the area of the cotton-wool spot: at presentation showing a maximum overall retinal thickness of 506 μm with focal thickening of the retinal nerve fiber layer (A); and 9 weeks later showing a corresponding overall retinal thickness of 229 μm (B). Abbreviations: RNFL, retinal nerve fibre layer; INL, inner nerve layer; IPL, inner plexiform layer; ONL, outer nuclear layer; OPL, outer plexiform layer.
See this image and copyright information in PMC

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