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August 1967

Cotton Wool Exudates in Systemic Amyloidosis

Author Affiliations

Bethesda, Md
From the Ophthalmology Branch, National Institute of Neurological Diseases and Blindness, National Institutes of Health, Public Health Service, US Department of Health, Education, and Welfare, Bethesda, Md. Dr. Crawford is now with the Armed Forces Institute of Pathology, Ophthalmic Pathology Branch, Washington, DC.

Arch Ophthalmol. 1967;78(2):214-216. doi:10.1001/archopht.1967.00980030216016

IN THIS same issue Wong and McFarlin1 report a case of primary amyloidosis with ocular involvement. A small localized vitreous veil over a retinal arteriole proved on histopathologic examination to be amyloid coming from the vessel. Another patient at the National Institutes of Health with amyloidosis had a similar appearing lesion on ophthalmoscopic examination. On postmortem examination, however, the lesion proved to be composed of swollen and degenerating axons in the nerve fiber layer of the retina ("cytoid bodies").

Report of a Case  A 35-year-old man who had previously been in good health except for mild hypertension noted the gradual onset of fatigue. Four months later a diagnosis of cardiomyopathy was made; and shortly thereafter, when mild icterus and hepatomegaly became apparent, a liver biopsy showed amyloidosis. There was no family history of such disease. He was admitted to the National Institute of Arthritis and Metabolic Diseases seven months

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