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Importance of an Ophthalmic Finding: Hollenhorst Plaques

 

Importance of an Ophthalmic Finding: Hollenhorst Plaques

Mario Nubile1*, Leonardo Mastropasqua1 and Paolo Rama2

1Ophthalmology Clinic, National Centre of High Technology (CNAT) in Ophthalmology, University of "G d'Annunzio", Chieti-Pescara, Italy
2Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Milano, Italy

*Corresponding author: Mario Nubile, Ophthalmology Clinic, National Centre of High Technology (CNAT) in Ophthalmology, University of "G d'Annunzio", Chieti-Pescara, Italy, E-mail: marnubile@unich.it

Received: May 29, 2021; Accepted: June 08, 2021; Published: June 21, 2021

Citation: Nubile M, Mastropasqua L, Rama P, et al. Importance of an Ophthalmic Finding: Hollenhorst Plaques. Clin Image Case Rep J. 2021; 3(6): 169.

Abstract

A 53-year-old woman presented with sudden, painless loss of vision in the left eye and vision of counting fingers. She was a known diabetic and hypertensive on medical management. Left eye retinal examination revealed retinal whitening at the posterior pole along with cherry red spot at the macula and presence of emboli called Hollenhorst plaques in the superotemporal and inferotemporal branches of the retinal arteries (arrows). Immediate ocular massage was done to dislodge the emboli but visual improvement was minimal. Carotid doppler and a full cardiac work-up was advised which was found to be normal. Hollenhorst plaques are cholesterol emboli, the most common form of emboli causing branch or central retinal artery occlusions. They are yellow, refractile and originate from carotid or aortic atherosclerotic plaques.

Hollenhorst plaques are important as they can be predictive of an impending ischemic stroke especially in the elderly. Immediate carotid doppler should be ordered in these patients to assess carotid artery stenosis as well as a cardiological work-up. If the lesion is ulcerated and causing more than 70% stenosis, the patient should be for stenting to an interventional radiologist [1].

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