Single isolated cotton-wool spots

The presence of isolated cotton-wool spots in normal fundi may indicate ser ious systemic disease. In this presentation 4 patients were examined for bl urred vision or scotomas with sudden onset. Two of them were pregnant. Fund uscopic examination revealed soft-appearing white spots in the temporal arc ades in 3 patients and in the papillomacular bundle in 1 patient. Due to th e lack of other fundus lesions 3 of the patients were initially treated for toxoplasmosis, The patients were seronegative for typical viral (HIV), ant inuclear antibodies, bacterial infections, or toxoplasmosis, Blood pressure s, glycosylated hemoglobin and blood counts were in the normal range, At th e follow-up examinations subjective symptoms had improved and the spots dis appeared or were smaller and showed more distinct borders, and no new lesio ns were detected. These cases suggest that isolated cotton-wool spots may o ccur without serious systemic disease in otherwise healthy subjects and the spots may be misinterpreted as acute inflammatory retinochoroidal lesions. Copyright (C) 2000 S. Karger AG, Basel.