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Bilateral Combined Retinal Vasculitis With Multiple Cotton Wool Spot-Like Lesions
Akshi Sharma1, Landon J Rohowetz2, Harry W Flynn2
1Department of Retina and Vitreous, LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India.
Ophthalmic Surgery, Lasers & Imaging Retina
|July 15, 2026
Summary
This case study highlights bilateral noninfectious retinitis with cotton wool spots, a rare form of retinal vasculitis. Prompt corticosteroid treatment led to rapid resolution of lesions.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Immunology
Background:
- Bilateral noninfectious retinitis is a rare condition.
- Cotton wool spot-like lesions can indicate underlying vascular compromise.
- Combined retinal vasculitis presents a diagnostic challenge.
Purpose of the Study:
- To present a unique case of bilateral noninfectious retinitis with cotton wool spot-like lesions and combined retinal vasculitis.
- To describe the diagnostic findings and treatment response in this rare condition.
Main Methods:
- Retrospective chart review of a 26-year-old female patient.
- Utilized Swept-source optical coherence tomography (SS-OCT) and Fundus fluorescein angiography (FFA).
- Conducted serological investigations and neuroimaging.
Main Results:
- The patient presented with bilateral combined retinal vasculitis and cotton wool spot-like lesions.
- SS-OCT showed a prominent middle limiting membrane (MLM) sign and cystoid macular edema.
- FFA revealed optic disc leakage without vascular leakage; ANA was positive.
- Rapid resolution of lesions occurred within 2 days of oral corticosteroid initiation.
Conclusions:
- This case demonstrates a rare presentation of bilateral noninfectious retinitis with combined retinal vasculitis.
- Early corticosteroid therapy is effective in managing such conditions.
- Long-term follow-up revealed optic disc pallor and retinal thinning post-resolution.
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