ISOLATED COTTON WOOL SPOTS IN YOUNG PATIENTS
A. Remky, O. Arend
The presence of isolated cotton- wool spots in normal fundi may indicate serious systemic disease. In this case report four young patients presented for an evaluation of blurred vision or scotomas. Two of the patients were pregnant. Funduscopic examination revealed soft appearing white spots in the temporal arcades in three patients and in the papillomacular bundle in the other. These locations corresponded to the sectorial perimetric defects. Fluorescein angiogram revealed hypofluorescent lesions without leakage. Due to their young age and lack of other fundus features three of the patients initially were treated for toxoplasmosis despite absence of vitreous cells. Results of blood samples were negative for typical viral, bacterial infections or toxoplasmosis. At the follow up subjective symptoms had improved and the spots were disappeared or smaller and showed more distict borders. These cases indicate that isolated cotton- wool spots may occur without serious systemic disease in otherwise healthy subjects and the spots had be misinterpreted as acute retinochoroidal lesions.
Augenklinik der RWTH Aachen, Pauwelsstr.30, 52057 Aachen