Cotton-wool spots and AIDS related complex

Twenty-nine patients with the AIDS Related Complex (ARC) were studied retrospectively. Cotton-wool spots (CWSs) were the main ophthalmological finding, present in 9 patients (31%) at this stage of the disease. The CWSs were asymptomatic and were therefore discovered during a routine examination. The proportion of patients with significant weight loss was greater among ARC patients with CWSs than among those with normal fundi. Leukocyte counts were found to be significantly lower (p = 0.03, odds ratio 10.0 [1.24 to 80.4]) among ARC patients with CWSs. Lymphocyte counts and the CD4/CD8 ratio were also found to be diminished in these patients. Among the nine patients with CWSs during ARC, seven developed major opportunistic infections or HIV (Human Immunodeficiency Virus) related neoplasias during the following months (3.8 +/- 3.5 months). These findings are consistent with a poorer prognosis for HIV infected patients who have CWSs.