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

Ioannides A, Georgakarakos ND, Elaroud I, Andreou P - Clin Ophthalmol (2011)

Bottom Line: Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time.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.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Department, Mid-Essex Hospitals NHS Trust, Chelmsford.

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.

No MeSH data available.


Related in: MedlinePlus

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.
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f3-opth-5-1431: 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.

Mentions: SD-OCT with Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA), also performed at presentation, showed marked retinal thickening corresponding to the area of the CWS (Figure 2A). The thickening was confined to the level of the retinal nerve fiber layer (Figure 3A).


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

Ioannides A, Georgakarakos ND, Elaroud I, Andreou P - Clin Ophthalmol (2011)

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.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198419&req=5

f3-opth-5-1431: 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.
Mentions: SD-OCT with Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA), also performed at presentation, showed marked retinal thickening corresponding to the area of the CWS (Figure 2A). The thickening was confined to the level of the retinal nerve fiber layer (Figure 3A).

Bottom Line: Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time.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.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Department, Mid-Essex Hospitals NHS Trust, Chelmsford.

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.

No MeSH data available.


Related in: MedlinePlus