Yellow White Things in the Retina

• Hard Exudate
• Distinctive Ophthalmoscopic Features: Deep yellow with sharp margins, often circinate
• Mechanism: Leakage from pre-capillary arterioles
• Common Associated Conditions: Diabetes, hypertension, von Hippel Lindau disease, radiation
• Cotton Wool Spot
  • Distinctive Ophthalmoscopic Features: Fluffy gray-white; usually near optic disc
    
  • Mechanism: Micro-infarction
  • Common Associated Conditions: Hypertension, diabetes, connective tissue disease, HIV
• Retinal Infiltrate
  • Distinctive Ophthalmoscopic Features: Near retinal vessels
  • Mechanism: Clump of leukocytes, sometimes forming granulomas, with organisms and necrotic retina
  • Common Associated Conditions: Sarcoid; leukemia; infection with candida, CMV, herpes simplex or zoster, lues
• Retinal Drusen
  • Distinctive Ophthalmoscopic Features: Clusters of yellow-orange spots, usually centered around fovea
  • Mechanism: Metabolic debris from retinal pigment epithelium
  • Common Associated Conditions: Age-related macular degeneration
• Chorioretinal Atrophy
  • Distinctive Ophthalmoscopic Features: Mostly white often with flecks of black pigment
  • Mechanism: Focal absence of retina and choroid
  • Common Associated Conditions: Toxoplasmosis, histoplasmosis, trauma, photocoagulation, congenital
• Intraluminal Plaque
  • Distinctive Ophthalmoscopic Features: Found at bifurcations; yellow means cholesterol-fibrin ("Hollenhorst plaque") white means calcium or talc
  • Mechanism: Embolism
  • Common Associated Conditions: Cervical carotid atherostenosis, calcified cardiac valve, IV drug abuse
• Myelinated Nerve Fibers
  • Distinctive Ophthalmoscopic Features: Feathery white clump usually connected to optic disc
  • Mechanism: Extension of myelin onto retinal ganglion cell axons
  • Common Associated Conditions: None