May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Analysis of Retinal Arterial Emboli found on Diabetic Retinopathy Screening By Digital Photography.
Author Affiliations & Notes
  • V. Khetpal
    Ophthalmology, Vanderbilt University, Nashville, TN
  • L.M. Merin
    Ophthalmology, Vanderbilt University, Nashville, TN
  • A. Chomsky
    Ophthalmology, Vanderbilt University, Nashville, TN
  • Footnotes
    Commercial Relationships  V. Khetpal, None; L.M. Merin, None; A. Chomsky, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4092. doi:
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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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Abstract

Abstract: : 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.

Keywords: diabetic retinopathy • vascular occlusion/vascular occlusive disease 
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