Retinal Platelet-fibrin (Hollenhorst) Embolus

  • Platelet-fibrin particle traveling from atheromatous cervical carotid bifurcation
  • Named after Robert Hollenhorst, MD, who noted its connection to diseased carotid artery
  • Usually causes transient vision loss as it first obstructs flow and then moves on distally
  • May cause persistent vision loss from segmental retinal infarct
  • Interpret this as sign of atheromatous cervical carotid disease
  • Refer urgently to ophthalmologist for confirmation or to internist for vascular imaging
  • Warning sign of unstable cervical carotid atheroma with potential for future stroke
  • Greatest threat of future stroke is within days of ophthalmic event