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Cotton-wool spots associated with pancreatic carcinoma
D Schmidt1, T Ness, M Geissler
1Universitaets-Augenklinik, Killianstr. 5, D-79106 Freiburg, Germany. schmidtd@aug.ukl.uni-freiburg.de
Background:
Malignant tumors of different organs may cause changes in the eye.
Patients:
A 62-year-old woman and a 47-year-old man who both had a metastasizing carcinoma of the pancreas suffered from visual disturbances.
Results:
The 62-year-old woman experienced cloudy vision in her left eye. The 47-year-old man noticed a left visual deterioration. Both patients exhibited cotton-wool spots in both eyes. In addition, the man revealed a metastasis of the choroid in the right eye. The woman was treated with Gemcitabine (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 termination 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 metastasizing carcinoma, suggesting the presence of a retinal ischemia. Therefore, early screening of patients with metastasizing pancreas carcinoma for retinal abnormalities may be important.