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Cotton Wool!

𝘚𝘰𝘧𝘵 𝘌𝘹𝘶𝘥𝘢𝘵𝘦𝘴/ 𝘊𝘰𝘵𝘵𝘰𝘯 𝘞𝘰𝘰𝘭 𝘚𝘱𝘰𝘵𝘴⁣ - Nerve fibre layer infarcts⁣ - Occur secondary to local ischemia from pre-capillary retinal arteriole obstruction → obstruction of axoplasmic flow in the nerve fibre layer → swelling of nerve fibres → white fluffy appearance → cotton wool spots ⁣

𝐂𝐚𝐮𝐬𝐞𝐬: ⁣ - Vascular Diseases : Diabetic Retinopathy, Hypertensive Retinopathy, Vein occlusions, Ocular Ischemic Syndrome, Papilledema, Radiation Retinopathy⁣ - Hematological Disorders: Anemia, Leukemia, Sickle Cells Anemia⁣ - Infectious Diseases: HIV Retinopathy, Neuroretinitis⁣ - Collagen vascular disorders: Giant Cell Arteritis, Behcet’s, SLE etc⁣ 𝐀𝐩𝐩𝐞𝐚𝐫𝐚𝐧𝐜𝐞:⁣ -Small, yellow white/ grayish white elevated lesions with a feathery border with striations parallel to the nerve fibres in the superficial retina⁣ -Obscures the underlying blood vessel⁣ -Commonly in posterior pole⁣ -Can resolve in weeks to months leaving a small depression known as ‘Depression Sign’⁣ -Other findings such as microaneurysms, retinal hemorrhages, hard exudates etc to be noted⁣ 𝐇𝐢𝐬𝐭𝐨𝐥𝐨𝐠𝐲:⁣ ‘Cytoid Bodies’⁣ - Looks like cells but are eosinophilic segments of ganglion cell axons that are swollen because of defective axoplasmic flow⁣ - Packed with accumulations of mitochondria and other intracellular material⁣ 𝐅𝐅𝐀:⁣ Hypofluorescence due to capillary non-perfusion in area corresponding to the cotton wool spot as well as blockage by axoplasm stasis⁣ 𝐎𝐂𝐓: ⁣ Hyper-reflective lesion in inner retinal layers ⁣ 𝐰𝐰𝐰.𝐨𝐩𝐡𝐭𝐡𝐚𝐥𝐦𝐨𝐛𝐲𝐭𝐞𝐬.𝐜𝐨𝐦⁣ Image from Rajan Eye Care Hospital ⁣ #ophthalmology #ophthal #retina #diabeticretinopathy #hypertensiveretinopathy #cottonwoolspots #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency

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