Single Cotton Wool Spot

Presenting Symptom: Cotton wool spots. Pathology: Cytoid bodies. Clinical: Although often classified as exudates, cotton wool spots are actually microinfarcts in the superficial, nerve-fiber layer and correspond to the focal necroses which pathologists term cytoid bodies. They are characteristically white with fimbriated edges due to the orientation of nerve fibers. They occur in a wide spectrum of diseases which induce focal ischemia. This 60-year old male with moderate hypertension demonstrates abnormalities in the fundus. In addition to the cotton wool spots, note the focal narrowing of the arteries and the conspicuous arteriovenous angulation. (The blue spot adjacent to the disc is a photographic artifact.). Disease/ Diagnosis: Retinal hemorrhage