Abstract
A 73-year-old man with hypertension and hyperlipidemia was seen in clinic complaining of decreased vision in his right eye. Bedside examination demonstrated a right eye inferior lateral visual field defect due to ischemic optic neuropathy and 2 bright intraluminal yellow plaques located in 2 different arteriolar bifurcations (figure). Carotid ultrasound showed an unstable, mobile, nonocclusive, ulcerated plaque in the right carotid bifurcation (see video on the Neurology® Web site at www.neurology.org). Hollenhorst plaques1 are cholesterol crystal emboli thought to originate from the ipsilateral carotid artery bifurcation that, in the absence of amaurosis fugax or stenosis, are not associated with an increased risk of ipsilateral cerebral infarct.2
A 73-year-old man with hypertension and hyperlipidemia was seen in clinic complaining of decreased vision in his right eye. Bedside examination demonstrated a right eye inferior lateral visual field defect due to ischemic optic neuropathy and 2 bright intraluminal yellow plaques located in 2 different arteriolar bifurcations (figure). Carotid ultrasound showed an unstable, mobile, nonocclusive, ulcerated plaque in the right carotid bifurcation (see video on the Neurology® Web site at www.neurology.org). Hollenhorst plaques1 are cholesterol crystal emboli thought to originate from the ipsilateral carotid artery bifurcation that, in the absence of amaurosis fugax or stenosis, are not associated with an increased risk of ipsilateral cerebral infarct.2
Figure. Fundus.
Retinal photograph showing 2 Hollenhorst plaques (arrows).
Supplementary Material
Footnotes
Supplemental data at www.neurology.org
AUTHOR CONTRIBUTIONS
Dr. Gonzalez-Castellon and Dr. Kadakia: study concept and design, acquisition of data, analysis or interpretation of data, and drafting of the manuscript. Dr. Willey: critical review of the manuscript for important intellectual content and study supervision. Dr. Rudich: study concept and design, acquisition of data, and analysis or interpretation of data. Dr. Odel: critical review of the manuscript for important intellectual content and study supervision.
STUDY FUNDING
No targeted funding reported.
DISCLOSURE
M. Gonzalez-Castellon, P. Kadakia, and J. Willey report no disclosures. Dr. Willey is funded by National Institute of Neurological Disorders and Stroke K23 NS 073104. D. Rudich reports no disclosures. J. Odel is a consultant for Bayer. Go to Neurology.org for full disclosures.
REFERENCES
- 1.Hollenhorst RW. Significance of bright plaques in the retinal arterioles. JAMA 1961;178:23–29 [DOI] [PubMed] [Google Scholar]
- 2.Dunlap AB, Kosmorsky GS, Kashyap VS. The fate of patients with retinal artery occlusion and Hollenhorst plaque. J Vasc Surg 2007;46:1125–1129 [DOI] [PubMed] [Google Scholar]
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