Splinter and Punctate Hemorrhages; Microaneurysms

Presenting Symptom: Cotton wool spots. Pathology: Cytoid bodies. Clinical: Central fundus of a diabetic patient showing multiple small splinter hemorrhages and many small round spots representing punctate hemorrhages and microaneurysms. (The latter two cannot be distinguished by ophthalmoscopy alone.) The splinter hemorrhages are situated superficially in the retina and owe their orientation to the horizontally coursing nerve fibers. The punctate hemorrhages are situated deep in the retina and owe their discrete departmentalization to the vertically coursing fibers. Disease/ Diagnosis: Retinal hemorrhage