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V. Khetpal, L.M. Merin, A. Chomsky; Analysis of Retinal Arterial Emboli found on Diabetic Retinopathy Screening By Digital Photography. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4092.
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Purpose: The goal of this study was to analyze the detection and medical evaluation of retinal arteriole emboli (hollenhorst plaques) found on diabetic retinal screening by digital photography. Methods: Study consisted of a retrospective review of 2207 patients, screened for diabetic retinopathy from May 2003 to December 2003. Digital Photographs from patients seen in a diabetic screening clinic were reviewed for the presence of arteriole emboli. A Chart review of these patients was done to identify a potential known source of the plaques and the impact these screening had on the patients’ work–up and treatment plan. Results: 24 eyes in 24 patients were found to have retinal arteriole emboli. 95% of these had a known cardiovascular disease. 12.5% of the patients presented with concurrent valvular heart disease while 25% had significant carotid artery stenosis. In 25% of the patients the source of the emboli could not be found. A new diagnosis was made in 10% of the patients who had no history and were asymptomatic. We also assessed physician responses to retinal arteriole findings. 66% of the patients were referred to cardiologist or vascular surgery for further evaluation. A change in medication was made in 88% of the patients in whom antiplatelet or statin therapy was initiated. In 16% of the patients, the primary care physician made no significant changes in treatment. Conclusions: Diabetic Retinopathy screening is an inexpensive and readily available tool. This study suggests the screening may have an additional utility in the identification high–risk patients with other serious medical conditions.
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