Optic disk edema with cotton-wool spots.

A 43-year-old man with high blood pressure developed visual loss in his left eye. He was found to have bilateral disk edema with cotton wool spots present in the temporal arcades and peripapillary hemorrhages. The presence of the cotton wool spots in the arcades is highly suggestive of hypertension as the etiology of the disk edema. The pathophysiology of cotton wool spots (inner retinal ischemic spots) due to focal ischemia from occlusion of terminal retinal arterioles is discussed.