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The presence of cotton wool spots may resolve independently over time, typically in 4–12 weeks, or may depend on the underlying disease causing the condition. [3] [4] Diagnosis and treatment of the underlying disease state may be beneficial in the treatment and management of cotton wool spots. [3]
Patients with branch retinal vein occlusion usually have a sudden onset of blurred vision or a central visual field defect. The eye examination findings of acute branch retinal vein occlusion include superficial hemorrhages, retinal edema, and often cotton-wool spots in a sector of retina drained by the affected vein.
Diabetic retinopathy (also known as diabetic eye disease) is a medical condition in which damage occurs to the retina due to diabetes.It is a leading cause of blindness in developed countries and one of the lead causes of sight loss in the world, even though there are many new therapies and improved treatments for helping people live with diabetes.
Advanced retinopathy lesions, such as microaneurysms, blot hemorrhages and/or flame hemorrhages, ischemic changes (e.g. "cotton wool spots"), hard exudates and in severe cases swelling of the optic disc (optic disc edema), a ring of exudates around the retina called a "macular star" and visual acuity loss, typically due to macular involvement.
As retinal abnormalities often begin in a particular layer of the retina before encroaching into the other layers (such as the formation of cotton wool spots in the nerve fiber layer), it is important to be able to appreciate depth when examining a fundus in order to provide an accurate diagnosis.
Examination findings may include microaneurysms, cotton wool spots, dot and blot hemorrhages, and neovascularization. [8] [10] Dilated fundus exam is the preferred method of diagnosis, as undilated exam may be too limited to visualize lesions or neovascularization that are more peripheral. [11]
Similar to hypertensive retinopathy, evidence of nerve fiber infarcts due to ischemia (cotton-wool spots) can be seen on physical exam. Symptoms may include headache, nausea, or vomiting. Chest pain may occur due to increased workload on the heart resulting in inadequate delivery of oxygen to meet the heart muscle's metabolic needs.
Common causes of scotomas include demyelinating disease such as multiple sclerosis (retrobulbar neuritis), damage to nerve fiber layer in the retina (seen as cotton wool spots [3]) due to hypertension, toxic substances such as methyl alcohol, ethambutol and quinine, nutritional deficiencies, vascular blockages either in the retina or in the optic nerve, stroke or other brain injury, and ...