Biomaterial Database

Cotton wool spots in AIDS: a review. 1994

R Wilson

New England College of Optometry, Beacon St., Boston, MA 02115.

BACKGROUND Cotton wool spots (CWS) result from infarctions of the retinal nerve fiber layer and are seen in a variety of clinical conditions. Most patients with human immunodeficiency virus (HIV) disease, the agent that causes the acquired immune deficiency syndrome (AIDS), demonstrate CWS at some point during their illness. CWS are the most prevalent ocular manifestation found in persons with AIDS. METHODS A review of the literature was conducted and interpreted to merge a variety of scientific data and clinical studies into a discussion of the etiology, pathophysiology, clinical significance and patient management approaches in patients with AIDS who have CWS. RESULTS Numerous studies demonstrate a relationship between CWS in patients with low CD4+ lymphocyte cell counts (< 50-100/mm3 of blood), the risk for HIV disease progression, and the development of opportunistic diseases. CONCLUSIONS While the overall clinical significance of CWS in AIDS is still evolving, it appears that CWS in healthy HIV positive patients have relatively little clinical significance. However, present data suggests that CWS in patients with very low CD4+ counts and advanced HIV disease is a negative prognostic sign. Therefore, CWS in profoundly immunosuppressed patients with low CD4+ counts should alert the optometrist to follow the patient closely.

UI	MeSH Term	Description	Entries
D007238	Infarction	Formation of an infarct, which is NECROSIS in tissue due to local ISCHEMIA resulting from obstruction of BLOOD CIRCULATION, most commonly by a THROMBUS or EMBOLUS.	Infarct,Infarctions,Infarcts
D007958	Leukocyte Count	The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells.	Blood Cell Count, White,Differential Leukocyte Count,Leukocyte Count, Differential,Leukocyte Number,White Blood Cell Count,Count, Differential Leukocyte,Count, Leukocyte,Counts, Differential Leukocyte,Counts, Leukocyte,Differential Leukocyte Counts,Leukocyte Counts,Leukocyte Counts, Differential,Leukocyte Numbers,Number, Leukocyte,Numbers, Leukocyte
D012164	Retinal Diseases	Diseases involving the RETINA.	Disease, Retinal,Diseases, Retinal,Retinal Disease
D005654	Fundus Oculi	The concave interior of the eye, consisting of the retina, the choroid, the sclera, the optic disk, and blood vessels, seen by means of the ophthalmoscope. (Cline et al., Dictionary of Visual Science, 4th ed)	Fundus of the Eye,Ocular Fundus,Fundus, Ocular
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000163	Acquired Immunodeficiency Syndrome	An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993.	AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D015496	CD4-Positive T-Lymphocytes	A critical subpopulation of T-lymphocytes involved in the induction of most immunological functions. The HIV virus has selective tropism for the T4 cell which expresses the CD4 phenotypic marker, a receptor for HIV. In fact, the key element in the profound immunosuppression seen in HIV infection is the depletion of this subset of T-lymphocytes.	T4 Cells,T4 Lymphocytes,CD4-Positive Lymphocytes,CD4 Positive T Lymphocytes,CD4-Positive Lymphocyte,CD4-Positive T-Lymphocyte,Lymphocyte, CD4-Positive,Lymphocytes, CD4-Positive,T-Lymphocyte, CD4-Positive,T-Lymphocytes, CD4-Positive,T4 Cell,T4 Lymphocyte