A Single Isolated Cotton-Wool Spot not Associated with Systemic Diseases.

Park, Sae Mi; Cho, In Hwan; Park, Tae Kwann; Ohn, Young Hoon

doi:2012.53.12.1898

J Korean Ophthalmol Soc > Volume 53(12); 2012 > Article

Case Report

Journal of the Korean Ophthalmological Society 2012;53(12):1898-1903.
DOI: https://doi.org/10.3341/jkos.2012.53.12.1898 Published online December 15, 2012.

A Single Isolated Cotton-Wool Spot not Associated with Systemic Diseases.

Sae Mi Park, In Hwan Cho, Tae Kwann Park, Young Hoon Ohn

Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. yhohn@schmc.ac.kr

전신질환이 없는 건강한 환자에서 나타난 단독 면화반 1예

박새미⋅조인환⋅박태관⋅온영훈

Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

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.

Key Words: Cotton-wool spot;Retinal nerve fiber layer defect;Systemic disease