Branch retinal artery occlusion

Branch retinal artery occlusion showing multiple
shiny multiple cholesterol emboli

An embolus from a calcific plaque at the 
bifurcation of the superior artery. The colour of 
the plaque is nearly identical to the optic disc and 
a casual examination may miss the sign.

In the examination you are unlikely to get a case of cherry red spot from central retinal artery because the sign 
usually disappears after 72 hours. Most cases of central retinal artery will be presented as optic atrophy or relative 
afferent pupillary defect. On the other hand, signs from emboli tend to remain longer and therefore more likely to 
appear in the examination.

The retinal artery shows cattle-trackings with multiple emboli. The emboli may be shiny if due to cholesterol crystals
(Hollenhorst plaque). In early stage, the retina may show retinal oedema.

Mention that you would like to:

  • perform a cardiovascular examination including listening for carotid bruit on the ipsilateral side.


1. What are the types of emboli which can cause branch retinal artery occlusion?

2. What is the significance of cilioretinal artery in central retinal artery?

3. What is the incidence of neovascularization in central retinal artery occlusion?

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