A white star-figure in the macular area of the retina is a typical ophthalmoscopic finding in advanced chronic diabetic and angiospastic retinopathy. It is composed of sharply limited white glistening spots which may be confluent and usually are arranged in a radiating manner around the fovea. These "hard" spots of the star-figure are ophthalmoscopically distinctly different from the "soft," fluffy, "cotton-wool" spots.
The histopathology of the macular star-figures in the retinae of two patients will be demonstrated in this study. Consideration will be given to the cause and manner of the development, as well as to the nature and significance, of this particular ophthalmoscopic finding. The histology of the typical cotton-wool spots in the retinae of a third patient will be described for comparison.
The present knowledge of the histopathology of the macular star-figure is composed of the findings of a large number of investigators and is very adequately summarized
WOLTER JR, GOLDSMITH RI, PHILLIPS RL. Histopathology of the Star-Figure of the Macular Area in Diabetic and Angiospastic Retinopathy. AMA Arch Ophthalmol. 1957;57(3):376-385. doi:10.1001/archopht.1957.00930050388009