Hollenhorst Plaques in Diabetic Retinopathy Screening

Abstract

Gradable photographs of 81 patients within the Birmingham, Solihull and Black Country diabetic retinopathy screening programme 2004-2011 where Hollenhorst plaque was used in the grading report were reviewed. 60 patients had cholesterol emboli at arteriolar bifurcations. 21 patients had arteriolar sheathing that, unlike cholesterol emboli, did not occur at arteriolar bifurcations and tended to persist unchanged. The aetiology of sheathing was not established but was found in an elderly population with macrovascular disease. The term Hollenhorst plaque should be avoided in retinopathy grading in order to avoid confusion between these different appearances.