The clinical import of a retinal cholesterol embolus: it is a question of symptoms

Paul Varner John J Pershing VA Medical Center, Poplar Bluff, MO, USA Abstract: Retinal cholesterol emboli (RCE) are occasionally found on ophthalmic examination. Originally, all RCE were thought to be related to impending cardiovascular morbidity and mortality, but it is now apparent that accompanyi...

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Main Author: Varner P
Format: Article
Language:English
Published: Dove Medical Press 2013-05-01
Series:Clinical Optometry
Online Access:http://www.dovepress.com/the-clinical-import-of-a-retinal-cholesterol-embolus-it-is-a-question--a12929
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author Varner P
author_facet Varner P
author_sort Varner P
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description Paul Varner John J Pershing VA Medical Center, Poplar Bluff, MO, USA Abstract: Retinal cholesterol emboli (RCE) are occasionally found on ophthalmic examination. Originally, all RCE were thought to be related to impending cardiovascular morbidity and mortality, but it is now apparent that accompanying symptoms can be used to help better stratify cardiovascular event risk for these patients. Regardless of associated visual symptoms, all patients with RCE but unknown medical status, merit referral to primary care providers for further assessment of cardiovascular health status. Symptomatic patients with known cardiovascular diseases require carotid duplex ultrasonography to determine degree of arteriolar occlusion with possible referral to vascular surgeons for invasive correction of carotid artery occlusive disease. Asymptomatic patients with known cardiovascular profiles may benefit from the addition of only 81 mg aspirin if not otherwise contraindicated. Screening carotid studies should not be considered for these patients. Carotid auscultation in the eye clinic setting is unwarranted for either set of patients. Keywords: retina, embolus, hollenhorst plaque
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spelling doaj.art-6d649208bef744099df647eb0108401b2022-12-21T18:49:14ZengDove Medical PressClinical Optometry1179-27522013-05-012013default1317The clinical import of a retinal cholesterol embolus: it is a question of symptomsVarner PPaul Varner John J Pershing VA Medical Center, Poplar Bluff, MO, USA Abstract: Retinal cholesterol emboli (RCE) are occasionally found on ophthalmic examination. Originally, all RCE were thought to be related to impending cardiovascular morbidity and mortality, but it is now apparent that accompanying symptoms can be used to help better stratify cardiovascular event risk for these patients. Regardless of associated visual symptoms, all patients with RCE but unknown medical status, merit referral to primary care providers for further assessment of cardiovascular health status. Symptomatic patients with known cardiovascular diseases require carotid duplex ultrasonography to determine degree of arteriolar occlusion with possible referral to vascular surgeons for invasive correction of carotid artery occlusive disease. Asymptomatic patients with known cardiovascular profiles may benefit from the addition of only 81 mg aspirin if not otherwise contraindicated. Screening carotid studies should not be considered for these patients. Carotid auscultation in the eye clinic setting is unwarranted for either set of patients. Keywords: retina, embolus, hollenhorst plaquehttp://www.dovepress.com/the-clinical-import-of-a-retinal-cholesterol-embolus-it-is-a-question--a12929
spellingShingle Varner P
The clinical import of a retinal cholesterol embolus: it is a question of symptoms
Clinical Optometry
title The clinical import of a retinal cholesterol embolus: it is a question of symptoms
title_full The clinical import of a retinal cholesterol embolus: it is a question of symptoms
title_fullStr The clinical import of a retinal cholesterol embolus: it is a question of symptoms
title_full_unstemmed The clinical import of a retinal cholesterol embolus: it is a question of symptoms
title_short The clinical import of a retinal cholesterol embolus: it is a question of symptoms
title_sort clinical import of a retinal cholesterol embolus it is a question of symptoms
url http://www.dovepress.com/the-clinical-import-of-a-retinal-cholesterol-embolus-it-is-a-question--a12929
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