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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.
An ophthalmoscopic view of the retina showing advanced signs of diabetic retinopathy including two pale cotton wool spots. Cotton wool spots are opaque fluffy white patches on the retina of the eye that are considered an abnormal finding during a funduscopic exam (also called an ophthalmoscopic exam). [1]
An exudate is a fluid released by an organism through pores or a wound, a process known as exuding or exudation. [1] Exudate is derived from exude 'to ooze' [ 2 ] from Latin exsūdāre 'to (ooze out) sweat' ( ex- 'out' and sūdāre 'to sweat').
Diabetic macular edema, with hard exudates surrounding the blood vessels. Macular edema occurs when fluid and protein deposits collect on or under the macula of the eye (a yellow central area of the retina) and causes it to thicken and swell ().
These changes are manifested in the retina as microaneurysms, hemorrhages, hard exudates, and cotton-wool spots. Swelling of the optic disk may occur at this time and usually indicates severely elevated blood pressure (i.e., malignant hypertension). Because better methods for the control of blood pressure are now available in the general ...
Retinal hemorrhages and hard exudates may be present on funduscopic exam. Hypertensive leukoencephalopathy may have concurrent cardiac ischemia and hematuria.
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Macular hard drusen in the right eye. 65-year-old diabetic woman. Drusen, from the German word for node or geode (singular, "Druse"), are tiny yellow or white accumulations of extracellular material that build up between Bruch's membrane and the retinal pigment epithelium of the eye.