Symmetrical Hollenhorst Emboli with Branch Retinal Artery Occlusion

Clinical Image

Austin J Clin Ophthalmol. 2019; 6(1): 1102.

Symmetrical Hollenhorst Emboli with Branch Retinal Artery Occlusion

Kumar A*, Ambiya V, Kapoor G, Arora A and Gaur S

¹Army College of Medical Sciences & Base Hospital Delhi Cantt, India-110010

*Corresponding author: Dr Ashok Kumar, Department of Ophthalmology, Army College of Medical Sciences & Base Hospital Delhi Cantt, India

Received: April 02, 2019; Accepted: April 15, 2019; Published: April 22, 2019

Clinical Image

A 50 year old man with a history of being known case of diabetes mellitus since 07 years presented to the ophthalmic emergency with sudden, profound diminution of vision in right eye of 05 days duration. His systemic parameters were normal and ocular examination revealed a best corrected visual acuity (BCVA) of 20/400 in right eye and 20/30 in left eye. Patient had normal reacting pupil in both eyes with early cortical cataract opacities in both eyes (Right>Left). Fundus examination of right eye revealed normal optic disc with two symmetrical yellowish, refractile cholesterol emboli (Hollenhorst plaques) in supero-tempora and inferotemporal branch of retinal artery (Figure 1A & 1B, blue arrow). Emboli in superotemporal retinal had lead to obstruction of artery with pale retina in its distribution and superior part of macula (Figure 1A & 1B, yellow arrow). Treatment with Tab acetazolamide 500mg stat, ocular massage along with paracentesis was done with no improvement in vision. Immediate cardiology consultation obtained which revealed cardiac emboli on trans-esophageal echocardiography but normal carotid Doppler. Patient was treated with anticoagulant, antiplatelet therapy with no evidence of adverse cardiac or neurological event on follow-up for next 02 months with some improvement in BCVA to 20/200. It’s a rare presentation of symmetrical retinal artery emboli involving superior and inferior retinal artery with branch retinal artery occlusion.

Citation: Kumar A, Ambiya V, Kapoor G, Arora A and Gaur S. Symmetrical Hollenhorst Emboli with Branch Retinal Artery Occlusion. Austin J Clin Ophthalmol. 2019; 6(1): 1102.