Is Carotid Ultrasound Necessary in the Evaluation of the Asymptomatic Hollenhorst Plaque?

      Hollenhorst plaques are cholesterol emboli deposited within retinal arterioles.
      • Bunt T.J.
      The clinical significance of the asymptomatic Hollenhorst plaque.
      A few studies have evaluated the relationship between Hollenhorst plaques and surgically correctable carotid disease.
      • Bunt T.J.
      The clinical significance of the asymptomatic Hollenhorst plaque.
      • Chawluk J.B.
      • Kushner M.J.
      • Bank W.J.
      • et al.
      Atherosclerotic carotid artery disease in patients with retinal ischemic syndromes.
      • Bull D.A.
      • Fante R.G.
      • Hunter G.C.
      • et al.
      Correlation of ophthalmic findings with carotid artery stenosis.
      • Wakefield M.C.
      • O'Donnell S.D.
      • Goff J.M.
      Re-evaluation of carotid duplex for visual complaints: who really needs to be studied?.
      • McCullough H.K.
      • Reinert C.G.
      • Hynan L.S.
      • et al.
      Ocular findings as predictors of carotid artery occlusive disease: is carotid imaging justified?.
      For patients with Hollenhorst plaques and symptoms of retinal ischemia, an evaluation for carotid occlusive disease is appropriate. However, there is a paucity of evidence and lack of consensus on the utility of carotid ultrasonography, and the workup and outcomes of patients with asymptomatic Hollenhorst plaques. Some authors
      • Bull D.A.
      • Fante R.G.
      • Hunter G.C.
      • et al.
      Correlation of ophthalmic findings with carotid artery stenosis.
      • Wakefield M.C.
      • O'Donnell S.D.
      • Goff J.M.
      Re-evaluation of carotid duplex for visual complaints: who really needs to be studied?.
      believe that an incidental Hollenhorst plaque could be a marker of a past embolic event and that the asymptomatic Hollenhorst plaque is a poor predictor of future embolic events.
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      References

        • Bunt T.J.
        The clinical significance of the asymptomatic Hollenhorst plaque.
        J Vasc Surg. 1986; 4: 559-562
        • Chawluk J.B.
        • Kushner M.J.
        • Bank W.J.
        • et al.
        Atherosclerotic carotid artery disease in patients with retinal ischemic syndromes.
        Neurology. 1988; 38: 858-863
        • Bull D.A.
        • Fante R.G.
        • Hunter G.C.
        • et al.
        Correlation of ophthalmic findings with carotid artery stenosis.
        J Cardiovasc Surg (Torino). 1992; 33: 401-406
        • Wakefield M.C.
        • O'Donnell S.D.
        • Goff J.M.
        Re-evaluation of carotid duplex for visual complaints: who really needs to be studied?.
        Ann Vasc Surg. 2003; 17: 635-640
        • McCullough H.K.
        • Reinert C.G.
        • Hynan L.S.
        • et al.
        Ocular findings as predictors of carotid artery occlusive disease: is carotid imaging justified?.
        J Vasc Surg. 2004; 40: 279-286

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