Retinal Microinfarct with Following Focal Defect of Nerve Fiber Layer (Colour-image, time course of 2 months)
Retinal Microinfarct with Following Focal Defect of Nerve Fiber Layer (Colour-image, time course of 2 months)
Within two months the intraretinal edema disappears. As a consequence a focal defect of the etinal nerve fiber layer becomes visible with an antero- and retrograde extension.
Cotton-wool spots correspond histologically to nerve fiber layer infarcts secondary to arteriolar ischemia.
Edema arises within the interrupted nerve fibers (end bulbs of Cajal). This is largely due to the interruption of axoplasmic flow. The final result is a whitish-yellow deposition of intra-axonal organelles.
The nerve fiber layer infarct might be associated with the "rheumatoid vasculitis" and rheumatoid arthritis in this patient.
Rheumatoid vasculitis may affect a wide range of blood vessel types, from medium-sized muscular arteries to somewhat smaller arterioles, to post-capillary venules. Within a given patient, clinical features of both medium- and small-vessel disease may be found. Rheumatoid vasculitis may lead to necrosis, blood vessel occlusion, and tissue ischemia in a manner that resembles other forms of systemic vasculitis.
Michelson, Georg, Prof. Dr. med., Augenklinik, Interdisziplinäres Zentrum für augenheilkundliche Präventivmedizin und Imaging, Friedrich-Alexander Universität Erlangen, Erlangen, Deutschland; Mardin, Christian, Prof. Dr. med., Augenklinik, Universität Erlangen-Nürnberg, Erlangen, Deutschland
