The COMS Grading Scheme: Graded Features

Cotton wool spots (soft exudates)

Superficial white, pale yellow-white or grayish-white areas with ill-defined (feathery) edges, frequently showing striations parallel to the nerve fiber layer are the lesions included.  These are distinct from the normal pattern of nerve fiber striations often seen along the superotemporal and inferotemporal arcades. 

Severity

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None: not present

Mild:  total area less than 1/2 disc area (standard photograph 1)

Cotton Wool Spots

Moderate: total area more than 1/2 disc area, but less than 1 disc area (standard photograph 2)

Cotton wool spots

Severe: total area more than 1 disc area

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last updated: 05-03-2006