Confluent cotton-wool spots in the central macula may simulate the cherry red spot that is seen in central retinal artery occlusion. Retinal microinfarcts that are seen in patients with fat embolization are usually smaller in size, located in the peripheral, not central, retina. Pigment migration and optic atrophy have been reported as late findings in the disease. Traumatic chest compression and blunt head trauma are common causes. Childbirth and the uncommon complication of amniotic fluid embolism are known risk factors.
Acute pancreatitis is a known risk factor.
The risk from acute pancreatitis may be due to fat embolization or complement activation with secondary leukocyte aggregation and occlusive vaculopathy. It may be diagnostic in presentations without an antecedent history of trauma. In patients with lupus, these antibodies may be associated with an increased risk of retinal vascular thrombosis. Obtain appropriate x-ray or imaging studies, if there is a history of head or thoracic trauma. Skull or rib fractures may be present.