Our patient was HIV positive with a CD4 count of 9.
There is an isolated nerve fiber layer infarct (cotton wool spot, CWS) in the right eye and two CWS in the left eye.
Learning Points:
Cotton-wool spots are nonspecific and are found in many disorders, including hypertensive and diabetic retinopathy. They can also be seen with HIV/AIDS when the CD4 count is under 200.
The etiology of CWS in HIV/AIDS is not known, although they do not contain virus particles.
