PMC3198419_01
Left fundus photographs: at presentation showing an isolated cotton-wool spot (A); and 9 weeks later showing resolution (B).
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Ocular examination showed an isolated CWS located between his left optic disc and macula (Figure 1A) but no other pathology. Fundoscopically, there was resolution of the CWS (Figure 1B) without any intervention.
Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA) retinal thickness maps: at presentation showing thickening (glowing red) of an area corresponding to the cotton-wool spot (A); and 9 weeks later showing focal thinning (B).
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SD-OCT with Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA), also performed at presentation, showed marked retinal thickening corresponding to the area of the CWS (Figure 2A). There was significant intraretinal thinning at the area of the lesion compared with adjacent healthy retina, evident on the retinal thickness map ( Figure 2B) as well as the longitudinal image (Figure 3B), although it was not clear which individual retinal layer levels were affected.
Cirrus HD-OCT (Carl Zeiss Meditec Inc, Dublin, CA) scans across the area of the cotton-wool spot: at presentation showing a maximum overall retinal thickness of 506 mum with focal thickening of the retinal nerve fiber layer (A); and 9 weeks later showing a corresponding overall retinal thickness of 229 mum (B).. Abbreviations: RNFL, retinal nerve fibre layer; INL, inner nerve layer; IPL, inner plexiform layer; ONL, outer nuclear layer; OPL, outer plexiform layer.
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The thickening was confined to the level of the retinal nerve fiber layer (Figure 3A). There was significant intraretinal thinning at the area of the lesion compared with adjacent healthy retina, evident on the retinal thickness map ( Figure 2B) as well as the longitudinal image (Figure 3B), although it was not clear which individual retinal layer levels were affected.