Cotton-wool spots associated with pancreatic carcinoma

Background: Malignant tumors of different organs may cause changes in the e ye. Patients: A 62-year-old woman and a 47-year-old man who both had a metastas izing carcinoma of the pancreas suffered from visual disturbances. Results: The 62-year-old woman experienced cloudy vision in her left eye. T he 47-year-old man noticed a left visual deterioration. Both patients exhib ited cotton-wool spots in both eyes. In addition, the man revealed a metast asis of the choroid in the right eye. The woman was treated with Gemcitabin e (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 t ermination 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 metas tasizing carcinoma, suggesting the presence of a retinal ischemia. Therefor e, early screening of patients with metastasizing pancreas carcinoma for re tinal abnormalities may be important.