1/16. Single isolated cotton-wool spots.The presence of isolated cotton-wool spots in normal fundi may indicate serious systemic disease. In this presentation 4 patients were examined for blurred vision or scotomas with sudden onset. Two of them were pregnant. Funduscopic examination revealed soft-appearing white spots in the temporal arcades in 3 patients and in the papillomacular bundle in 1 patient. Due to the lack of other fundus lesions 3 of the patients were initially treated for toxoplasmosis. The patients were seronegative for typical viral (hiv), antinuclear antibodies, bacterial infections, or toxoplasmosis. blood pressures, glycosylated hemoglobin and blood counts were in the normal range. At the follow-up examinations subjective symptoms had improved and the spots disappeared or were smaller and showed more distinct borders, and no new lesions were detected. These cases suggest that isolated cotton-wool spots may occur without serious systemic disease in otherwise healthy subjects and the spots may be misinterpreted as acute inflammatory retinochoroidal lesions.- - - - - - - - - - ranking = 1keywords = cotton (Clic here for more details about this article) |
2/16. Cotton-wool spots associated with pancreatic carcinoma.BACKGROUND: Malignant tumors of different organs may cause changes in the eye. patients: A 62-year-old woman and a 47-year-old man who both had a metastasizing carcinoma of the pancreas suffered from visual disturbances. RESULTS: The 62-year-old woman experienced cloudy vision in her left eye. The 47-year-old man noticed a left visual deterioration. Both patients exhibited cotton-wool spots in both eyes. In addition, the man revealed a metastasis of the choroid in the right eye. The woman was treated with Gemcitabine (1999), and the man with 5 Fluo-uracil/Leukovorin (1997). The cotton-wool spots were reduced in size in the woman after treatment with Gemcitabine. The patients had no diabetes mellitus and no arterial hypertension. After termination of treatment, their general condition deteriorated and they died within a few weeks. CONCLUSION: Cotton-wool spots are unusual findings in the retina of a metastasizing carcinoma, suggesting the presence of a retinal ischemia. Therefore, early screening of patients with metastasizing pancreas carcinoma for retinal abnormalities may be important.- - - - - - - - - - ranking = 0.33333333333333keywords = cotton (Clic here for more details about this article) |
3/16. Retinopathy associated with high-dose interferon alfa-2b therapy.PURPOSE: To present seven patients who developed retinopathy while receiving high-dose interferon alfa-2b therapy for adjuvant treatment of high-risk melanoma. methods: Retrospective case series. RESULTS: Seven patients developed a retinopathy while receiving high-dose interferon alfa-2b therapy for adjuvant treatment of high-risk melanoma. Five patients had normal visual acuity, but retinopathy with cotton- wool spots and/or retinal hemorrhages with the retinopathy resolved after stopping treatment after detection. Two patients developed severe retinopathy with vision loss to counting fingers and hand motions without resolution of the retinopathy. The duration of the maintenance treatment before detection of the retinopathy for all patients ranged from 6 to 26 weeks. The total dose received at time of detection of retinopathy ranged from 816 to 1770 million units. Confounding factors included hypertension, thrombocytopenia, anemia, and a history of prior chemotherapy in one patient. Also, one patient received an investigational ganglioside vaccine, one had a history of radiation treatment to the brain, and six received paroxetine. CONCLUSIONS: patients receiving interferon alfa-2b are at risk for developing an associated retinopathy. The risk appears to be greater with higher dosage therapy. In addition, severe vision loss can be seen with interferon alfa-2b-associated retinopathy. The effect of treatment with selective serotonin reuptake inhibitors, such as paroxetine, in increasing the incidence of this complication is unknown. patients need to be monitored until the retinopathy is resolved to screen for sequelae, including retinal neovascularization.- - - - - - - - - - ranking = 0.16666666666667keywords = cotton (Clic here for more details about this article) |
4/16. Nerve fiber bundle visual field defect resulting from a giant peripapillary cotton-wool spot.Cotton-wool spots are the clinical manifestation of focal infarcts of the retinal nerve fiber layer. They rarely cause significant visual field loss. A large idiopathic cotton-wool spot in a 34-year-old healthy woman caused a nerve fiber bundle visual field defect and an afferent pupillary defect that remained after the cotton-wool spot had disappeared and the retina and optic nerve appeared normal.- - - - - - - - - - ranking = 1keywords = cotton (Clic here for more details about this article) |
5/16. Bilateral decreased vision and cotton-wool spots in a 42-year-old man.A 42-year-old man presented with bilateral decreased vision, transient visual loss, and anterior segment inflammation. The diagnosis of ocular ischemic syndrome was established by arteriography.- - - - - - - - - - ranking = 0.66666666666667keywords = cotton (Clic here for more details about this article) |
6/16. Progressive visual loss due to a muslinoma--report of a case and review of the literature.Intracranial internal carotid artery (ICA) aneurysms are frequently treated either by microsurgical clipping of the aneurysm neck, by endovascular coiling of the aneurysm sac or by balloon occlusion of the parent vessel. For some broad-based aneurysms that may not be suitable for any of these options, microsurgical wrapping of the aneurysm wall with muslin or gauze rarely is applied. We report the case of a patient who suffered from a minor stroke because of arterio-arterial embolism from an intracranial ICA aneurysm. The aneurysm was treated by wrapping muslin material. After 12 months, he experienced progressive visual loss. Cranial magnetic resonance testing magnetic resonance tomography (MRT) revealed a granulomatous inflammation surrounding the site of the aneurysm and affecting optochiasmatic structures. A muslin-induced optic neuropathy is a rare but serious complication of a chronic inflammatory reaction in response to muslin or gauze used in intracranial aneurysm wrapping. If the foreign body inflammatory reaction to muslin or gauze leads to a mass formation, the term muslinoma or gauzoma is applied. Various treatment strategies include surgery, steroids and cyclophosphamide, but recovery of the vision is not predictable. As a consequence, muslin or cotton gauze should only be applied with great caution in neurovascular surgery.- - - - - - - - - - ranking = 0.16666666666667keywords = cotton (Clic here for more details about this article) |
7/16. Visual dysfunction caused by gauze wrapping of an intracranial aneurysm.A 43-year-old woman developed right frontal headache and decreased vision in her OD 14 months after treatment of an intracranial aneurysm by wrapping with cotton gauze. A junctional visual field defect was present, and an MRI revealed a contrast-enhancing mass involving the right optic nerve, lateral chiasm, optic tract, and cavernous sinus. biopsy demonstrated a marked inflammatory reaction mixed with strands of birefringent cotton gauze. Despite treatment with high-dose corticosteroids, visual loss progressed to bilateral blindness. This is the 30th reported case of an intracranial inflammatory tumor developing from a gauze-wrapped aneurysm ("gauzoma" or "muslinoma") and the worst reported visual outcome. Most cases have occurred in women and involved the optic nerves or chiasm. Visual improvement has sometimes occurred after treatment with abscess drainage, debulking, and/or corticosteroids. A rare complication of aneurysm wrapping, gauzomas causing visual loss have been reported up to 54 months after surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = cotton (Clic here for more details about this article) |
8/16. Ocular manifestations in Dengue fever.PURPOSE: To report a case of Dengue fever resulting in permanent visual loss in both eyes due to retinal capillary occlusion. methods: Case report. RESULTS: Severe permanent visual loss occurred in a patient with Dengue fever. Dilated fundus exam showed vascular sheathing with associated retinal hemorrhages at the equator and cotton wool spots in the maculae of both eyes. fluorescein angiography revealed areas of capillary nonperfusion at the equator and in the macula. The diagnosis of Dengue fever was confirmed by serology detecting IgM antibodies to the dengue virus. CONCLUSION: Ocular abnormalities may be seen in patients with Dengue fever, therefore ophthalmoscopy should be performed in patients presenting with severe forms of the disease.- - - - - - - - - - ranking = 0.16666666666667keywords = cotton (Clic here for more details about this article) |
9/16. Clinical course of macular edema in two cases of interferon-associated retinopathy observed by optical coherence tomography.BACKGROUND: Interferon (IFN)-associated retinopathy is typically characterized by retinal hemorrhages and cotton wool spots at the posterior fundus, but visual function is usually maintained. With the use of optical coherence tomography (OCT), two patients with IFN-associated retinopathy who had developed macular edema and reduced visual acuity during the clinical course of IFN therapy were observed. CASES: A 37-year-old man with chronic hepatitis c and a 59-year-old man with chronic myeloid leukemia, both of whom had received IFN therapy, were referred to our outpatient clinic. The former patient had complained once that his visual acuity had decreased after the termination of IFN therapy, and the latter patient complained twice during IFN therapy that his visual acuity had decreased. OBSERVATIONS: In both patients, at the time of the visual disturbances, macular edema was clearly observed by OCT. hypoalbuminemia and thrombocytopenia were observed at this time also. After the remission of the hypoalbuminemia and thrombocytopenia, the macular edema observed by OCT disappeared and visual acuity returned to normal. CONCLUSION: During and after IFN therapy, OCT is a useful examination technique for revealing macular edema in patients who have decreased vision. Ophthalmologists should be aware of the ocular side effects of IFN therapy and carefully monitor patients for the possible occurrence of hypoalbuminemia and thrombocytopenia. Jpn J Ophthalmol 2005;49:231-234 (c) Japanese Ophthalmological Society 2005.- - - - - - - - - - ranking = 0.16666666666667keywords = cotton (Clic here for more details about this article) |
10/16. Purtscher's retinopathy after fracture dislocation of shoulder joint.Purtscher described sudden blindness in patients with severe head trauma due to a remote retinopathy, characterised by bilateral retinal haemorrhages, cotton wool spots, and optic disc swelling seen on fundoscopy. A similar retinopathy has been reported in compressive chest trauma, long bone fractures, and acute pancreatitis. It is less well recognised that Purtscher's retinopathy can occur unilaterally and following less severe trauma. We present a case of unilateral remote traumatic retinal angiopathy following a fracture dislocation of the shoulder joint.- - - - - - - - - - ranking = 0.16666666666667keywords = cotton (Clic here for more details about this article) |
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