Article

Asymptomatic Carotid Artery Stenosis

7 September 2023

A 76-year-old, asymptomatic male presented for a routine eye examination. His medical and ocular histories were unremarkable except for an oral statin for hyperchlorestolemia. Clinical Findings: Fundus photography revealed a Hollenhorst plaque OD. An urgent carotid duplex showed carotid arteriolar stenosis of right 50-69%, left 15% due to arteriosclerosis. Patient is awaiting surgical evaluation for right carotid endarterectomy.

Courtesy of Dr. Adam Barron, OD., Heron Eyecare
Bright yellow refractile lesion located at the bifurcation of a right superotemporal retinal arteriole.
Courtesy of Dr. Adam Barron, OD., Heron Eyecare
Enhanced visualization using Green LED channel separations reveals lesion inside the lumen of the retinal arteriole

The stability and comfort of an integrated head/chin rest and less than 0.2-second image acquisition minimized artifacts and facilitated a confident diagnosis of the Hollenhorst plaque. A quickly taken true color, widefield image of the retina uncovered a subtle, incidental finding, giving practitioners the opportunity to prevent a potentially life-threatening event.

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