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Enigmatic Cotton Wool Spot
Aug 6, 2001

I have tested negative for HIV twice now, and have been with the same person for nearly 2 years.

I am 22 years old. 3 months ago I developed a cotton wool spot during a game of basketball. I had no trauma.

After seeing several opthamologists they were not able to determine a cause. I am not diabetic, though I am slightly systolic hypertensive (140/65 typical bp)

I was worrried about HIV, and thus had 2 ab tests but was negative both times. The angiogram I had revealed no other hemorages.

The doctors said my retina looks perfect now, and can see no signs of any systemic or retinal disease.

I specifically asked one op if my retina looked like it might have CMV, but he said it looked perfect.

Additionally, I seem to notice more floaters now.

Should I be tested for HIV again. What else could have caused this spot?

Response from Dr. Feinberg

A cotton wool spot occurs when a blood vessel in the nerve fiber layer of the retina gets closed off, causing an "infarct" of that area. Cotton wool spots can sometimes be mistaken for CMV lesions. Yours may have been associated with your hypertension, but if it has resolved, your eyes look normal and you are HIV-, I don't think it's anything to be concerned about.


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