Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What is the most common retinal finding in patients with AIDS?

1. Cotton wool spots

2. Retinal hemorrhages

3. Optic disc edema

4. Macular degeneration

The correct answer is: Cotton wool spots

The most common retinal finding in patients with AIDS is cotton wool spots. These small, fluffy white patches on the retina are indicative of localized ischemia, which occurs when there is a lack of blood supply to the nerve fiber layer of the retina. In immunocompromised individuals, such as those with AIDS, the likelihood of developing vascular issues is increased due to underlying conditions associated with the disease, including opportunistic infections and systemic inflammation. Cotton wool spots are often seen in various conditions, including diabetes and hypertension, but their presence in the context of AIDS has been more frequently documented. This is significant as it indicates both the systemic effects of the virus and the inflammatory response that can compromise the retinal vasculature. While retinal hemorrhages, optic disc edema, and macular degeneration can also occur in the context of AIDS due to various factors, including opportunistic infections like cytomegalovirus retinitis, these findings are less specific and not as commonly encountered as cotton wool spots in the general AIDS population. Thus, recognizing cotton wool spots as a prevalent finding helps in assessing the ocular health of patients living with AIDS, making it an important detail for effective clinical evaluation and management.