A Single Isolated Cotton-Wool Spot not Associated with Systemic Diseases.
10.3341/jkos.2012.53.12.1898
- Author:
Sae Mi PARK
1
;
In Hwan CHO
;
Tae Kwann PARK
;
Young Hoon OHN
Author Information
1. Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. yhohn@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Cotton-wool spot;
Retinal nerve fiber layer defect;
Systemic disease
- MeSH:
Adult;
Dental Caries;
Eye;
Female;
Follow-Up Studies;
Humans;
Nerve Fibers;
Reference Values;
Retina;
Retinaldehyde;
Rheumatoid Factor;
Tomography, Optical Coherence;
Visual Field Tests
- From:Journal of the Korean Ophthalmological Society
2012;53(12):1898-1903
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To present a case of a single isolated cotton-wool spot in a healthy patient. CASE SUMMARY: A 43-year-old woman with no systemic disease complained of sudden inferior field defect of the right eye. On fundoscopic examination of the right eye, a single soft white spot was observed in the superotemporal vascular arcade. An elevated hyper-reflective area in the inner retina corresponding to a white spot was observed on optical coherence tomography. Automated perimetry revealed an arcuate field defect which was wider than the cotton-wool spot. A complete workup for systemic diseases was within normal range except a positive rheumatoid factor. At the 2-week follow-up, the patient's subjective symptom improved and the white spot decreased. After 6 months, the cotton-wool spot disappeared and slit-like retinal nerve fiber layer (RNFL) defects corresponding to the location of the cotton-wool spot was noticed. One year later, disc and RNFL defect were unchanged but the previous field defect disappeared. CONCLUSIONS: Isolated cotton-wool spots can occur without serious systemic diseases in healthy patients. A single isolated cotton-wool spot in the present case disappeared spontaneously leaving permanent structural damage on the retina over time.
