During a fundoscopic exam, dull, yellowish-white retinal lesions are most likely Cotton wool spots. Which option best completes this statement?

During a fundoscopic exam, dull, yellowish-white retinal lesions are most likely Cotton wool spots. Which option best completes this statement?

• A. Cotton wool spots
• B. Microaneurysms
• C. Hemorrhages
• D. Exudates

Answer: (A)

Cotton-wool spots arise from ischemia of the retinal nerve fiber layer, creating microinfarcts that appear as dull, yellowish-white, fluffy patches on the retina. This appearance—ill-defined, pale patches—reflects axoplasmic flow stasis in the nerve fiber layer and is commonly seen in conditions with microvascular ischemia, such as diabetic and hypertensive retinopathy. Understanding the look helps distinguish them from other retinal lesions: microaneurysms are tiny red dots representing localized vascular dilation; hemorrhages are red patches in the nerve fiber layer, often flame-shaped; hard exudates are bright yellow, well-circumscribed deposits of lipid. Given the description of dull, yellowish-white patches, cotton-wool spots are the most fitting finding.

Cotton-wool spots arise from ischemia of the retinal nerve fiber layer, creating microinfarcts that appear as dull, yellowish-white, fluffy patches on the retina. This appearance—ill-defined, pale patches—reflects axoplasmic flow stasis in the nerve fiber layer and is commonly seen in conditions with microvascular ischemia, such as diabetic and hypertensive retinopathy.

Understanding the look helps distinguish them from other retinal lesions: microaneurysms are tiny red dots representing localized vascular dilation; hemorrhages are red patches in the nerve fiber layer, often flame-shaped; hard exudates are bright yellow, well-circumscribed deposits of lipid. Given the description of dull, yellowish-white patches, cotton-wool spots are the most fitting finding.