Isolated retinal cotton wool spot after coronary angiography
A 50-year-old woman was referred to our clinic for acute onset of blurred vision in her right eye 12 h after coronary angiography for cardiac palpitation.\nHer coronary angiography was uneventful and revealed coronary artery spasm. The procedure lasted 20 min during which the patient remained hemodynamically stable. Twelve hours after catheterization the patient complained of sudden blurred and patchy vision in the right eye.\nComputed tomography scan of the patient’s brain was performed immediately to exclude a contrast induced transient cortical blindness, but it was unremarkable and the patient was referred to the department of ophthalmology.\nOn examination, the visual acuity (VA) was 6/6 in the right and 6/5 in the left eye. The patient had a history of hypertension and hypercholesterolemia and was not on any medications. Intraocular pressures were 14 mm Hg both sides and slit lamp examination showed a deep anterior chamber. Fundoscopy of the right eye revealed a tiny single parafoveal whitish patch in the right macula, suggestive of an isolated cotton wool spot. Amsler grid test showed a parafoveal scotoma corresponding to the area of the cotton wool spot. The left funduscopy findings were unremarkable [].\nOptical coherence tomography (OCT) was performed and showed an isolated opacity in the level of the retinal nerve fiber layer corresponding to the cotton wool spot [].\nSince the lady was under the care of cardiology, no further treatment was suggested from ophthalmological point of view, and she was started on diltiazem 120 mg daily for her coronary artery spasm by her cardiologist.\nOn review 6 weeks later, the symptoms had improved and VA was 6/6 in both eyes. Fundoscopy and Amsler grid test of the right eye were unremarkable. OCT scan showed a complete resolution of the cotton wool spot [].