Nerve fiber bundle visual field defect resulting from a giant peripapillary cotton-wool spot.

Cotton-wool spots are the clinical manifestation of focal infarcts of the retinal nerve fiber layer. They rarely cause significant visual field loss. A large idiopathic cotton-wool spot in a 34-year-old healthy woman caused a nerve fiber bundle visual field defect and an afferent pupillary defect that remained after the cotton-wool spot had disappeared and the retina and optic nerve appeared normal.