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Cotton Wool!

๐˜š๐˜ฐ๐˜ง๐˜ต ๐˜Œ๐˜น๐˜ถ๐˜ฅ๐˜ข๐˜ต๐˜ฆ๐˜ด/ ๐˜Š๐˜ฐ๐˜ต๐˜ต๐˜ฐ๐˜ฏ ๐˜ž๐˜ฐ๐˜ฐ๐˜ญ ๐˜š๐˜ฑ๐˜ฐ๐˜ต๐˜ดโฃ โฃ - Nerve fibre layer infarctsโฃ โฃ - Occur secondary to local ischemia from pre-capillary retinal arteriole obstruction โ†’ obstruction of axoplasmic flow in the nerve fibre layer โ†’ swelling of nerve fibres โ†’ white fluffy appearance โ†’ cotton wool spots โฃ

โฃ โฃ ๐‚๐š๐ฎ๐ฌ๐ž๐ฌ: โฃ โฃ - Vascular Diseases : Diabetic Retinopathy, Hypertensive Retinopathy, Vein occlusions, Ocular Ischemic Syndrome, Papilledema, Radiation Retinopathyโฃ โฃ - Hematological Disorders: Anemia, Leukemia, Sickle Cells Anemiaโฃ โฃ - Infectious Diseases: HIV Retinopathy, Neuroretinitisโฃ โฃ - Collagen vascular disorders: Giant Cell Arteritis, Behcetโ€™s, SLE etcโฃ โฃ โฃ ๐€๐ฉ๐ฉ๐ž๐š๐ซ๐š๐ง๐œ๐ž:โฃ โฃ -Small, yellow white/ grayish white elevated lesions with a feathery border with striations parallel to the nerve fibres in the superficial retinaโฃ โฃ -Obscures the underlying blood vesselโฃ โฃ -Commonly in posterior poleโฃ โฃ -Can resolve in weeks to months leaving a small depression known as โ€˜Depression Signโ€™โฃ โฃ -Other findings such as microaneurysms, retinal hemorrhages, hard exudates etc to be notedโฃ โฃ ๐‡๐ข๐ฌ๐ญ๐จ๐ฅ๐จ๐ ๐ฒ:โฃ โฃ โ€˜Cytoid Bodiesโ€™โฃ โฃ - Looks like cells but are eosinophilic segments of ganglion cell axons that are swollen because of defective axoplasmic flowโฃ โฃ - Packed with accumulations of mitochondria and other intracellular materialโฃ โฃ โฃ ๐…๐…๐€:โฃ โฃ Hypofluorescence due to capillary non-perfusion in area corresponding to the cotton wool spot as well as blockage by axoplasm stasisโฃ โฃ ๐Ž๐‚๐“: โฃ โฃ Hyper-reflective lesion in inner retinal layers โฃ โฃ ๐ฐ๐ฐ๐ฐ.๐จ๐ฉ๐ก๐ญ๐ก๐š๐ฅ๐ฆ๐จ๐›๐ฒ๐ญ๐ž๐ฌ.๐œ๐จ๐ฆโฃ โฃ Image from Rajan Eye Care Hospital โฃ #ophthalmology #ophthal #retina #diabeticretinopathy #hypertensiveretinopathy #cottonwoolspots #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident#ophthalmologyresident #ophthalmologyresidency#ophthalmologyresidency

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