Cotton Wool
๐๐ฐ๐ง๐ต ๐๐น๐ถ๐ฅ๐ข๐ต๐ฆ๐ด/ ๐๐ฐ๐ต๐ต๐ฐ๐ฏ ๐๐ฐ๐ฐ๐ญ ๐๐ฑ๐ฐ๐ต๐ดโฃ โฃ
Nerve fibre layer infarctsโฃ โฃ
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 โฃ
๐๐๐ฎ๐ฌ๐๐ฌ: โฃ โฃ
Vascular Diseases : Diabetic Retinopathy, Hypertensive Retinopathy, Vein occlusions, Ocular Ischemic Syndrome, Papilledema, Radiation Retinopathyโฃ โฃ
Hematological Disorders: Anemia, Leukemia, Sickle Cells Anemiaโฃ โฃ
Infectious Diseases: HIV Retinopathy, Neuroretinitisโฃ โฃ
Collagen vascular disorders: Giant Cell Arteritis, Behcetโs, SLE etcโฃ โฃ โฃ
๐๐ฉ๐ฉ๐๐๐ซ๐๐ง๐๐:โฃ โฃ
Small, yellow white/ grayish white elevated lesions with a feathery border with striations parallel to the nerve fibres in the superficial retinaโฃ โฃ
Obscures the underlying blood vesselโฃ โฃ
Commonly in posterior poleโฃ โฃ
Can resolve in weeks to months leaving a small depression known as โDepression Signโโฃ โฃ
Other findings such as microaneurysms, retinal hemorrhages, hard exudates etc to be notedโฃ โฃ
๐๐ข๐ฌ๐ญ๐จ๐ฅ๐จ๐ ๐ฒ:โฃ โฃ
โCytoid Bodiesโโฃ โฃ - Looks like cells but are eosinophilic segments of ganglion cell axons that are swollen because of defective axoplasmic flowโฃ โฃ
Packed with accumulations of mitochondria and other intracellular materialโฃ โฃ โฃ
๐ ๐ ๐:โฃ โฃ Hypofluorescence due to capillary non-perfusion in area corresponding to the cotton wool spot as well as blockage by axoplasm stasisโฃ โฃ
๐๐๐: โฃ โฃ Hyper-reflective lesion in inner retinal layers โฃ โฃ
๐ฐ๐ฐ๐ฐ.๐จ๐ฉ๐ก๐ญ๐ก๐๐ฅ๐ฆ๐จ๐๐ฒ๐ญ๐๐ฌ.๐๐จ๐ฆโฃ โฃ
Image from Rajan Eye Care Hospital โฃ
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