Hollenhorst plaque Images, ICD-10, Definition, Symptoms, Causes, Treatment

   

Hollenhorst plaques are cholesterol emboli found at the bifurcation of the retinal arteries. The source of these emboli is generally the heart or carotid arteries. They are usually unilateral and occur in elderly patients with advanced atherosclerosis. Symptoms of fugitive alteration of vision may accompany these emboli.

Light yellow deposit usually stick to the peripheral artery at the bifurcation of a peripheral arteriole due to which they cause occlusion of branch retinal artery. This often appears larger than the artery where it is and sometimes you can even see it during migrating down. Migration can be facilitated by lightly massaging the eyeball. It is an arterial cholesterol embolism from an atheromatous plaque ulcer in a proximal artery, usually the internal carotid artery.

Usually embolism associated with retinal artery are often termed as hollenhorst plaque. Due to insignificant symptoms they often diagnosed during routine checkups but appearance of several emboli over time in the arterial tree gives temporary vision loss for seconds at a time. Loss of vision occurs because a temporary artery occlusion occurs, followed by a break of embolism, the components are taken down into the fine capillary system. Larger embolism can be lodged in a vessel permanently and cause massive ischemia in the part of the retina, with permanent loss. In some cases, larger emboli settle down in retinal artery with no obvious symptom in general. This is usually due to the blood flowing around the embolus and continuing retinal tissue supply.

Hollenhorst plaque Images


Hollenhorst plaque Images, ICD-10, Definition, Symptoms, Causes, Treatment

Hollenhorst plaque Images, ICD-10, Definition, Symptoms, Causes, Treatment

Hollenhorst plaque Symptoms


Usually patient remains asymptomatic in case of small emboli. It is often diagnosed during routing examination of eye. If the large sized emboli deposit in retinal artery then sudden vision loss just for few second or blurry vision for few seconds might be a major symptom of Hollenhorst plaque. Usually white color deposits occur due to deposition of calcium while yellowish appearance reveals the deposition of cholesterol.

Hollenhorst plaqueCauses


There number of causes that trigger hollenhorst plaque. These are diabetes mellitus, atherosclerosis, hypercholesterolemia, blood thickening, geriatric patients. However, about 60% cases of hollenhorst plaque are mainly due to diabetes mellitus so, patients having diabetes are more prone get hollenhorst plaque.

Hollenhorst plaque Treatment


Hollenhorst plaque is alarming condition because patient is at high risk to have hemorrhage, stroke, myocardial infarction, circulatory disorder etc. A prompt strategy to minimize such problems is usage of blood thinning agents like aspirin, low molecular weight heparin and anti-clotting agents.  Similarly, if patient is diabetic he must control his/her diabetes by using insulin or other anti-diabetic agents like metformin etc.

Hollenhorst plaque ICD-10


Following code is used for Hollenhorst plaque in ICD-10

H34.219--Partial retinal artery occlusion, unspecified eye--Billable

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