Multiple Fresh Emboli (Lipidic)

Presenting Symptom: Loss of vision OD. Pathology: Embolism. Clinical: The patient was a 60-year old male who lost practically all vision in the right eye after a violent sneezing episode. Examination one hour after the event showed several yellowish white emboli obstructing the circulation. The present photograph taken the following day shows further fragmentation of the emboli with an especial tendency to lodge at the point of arterial bifurcation. The retina shows the familiar opacification of acute ischemia with sparing in the region of the small cilioretinal artery. Characteristic of lipid emboli, as represented here, is their tendency to fragment and to pass toward the periphery. The source of such emboli is usually atheromatous ulceration of the carotid artery. (The several dark spots are photographic artifacts.) Disease/ Diagnosis: Atherosclerotic plaque within cilioretinal artery