Cholesterol emboli are seen on funduscopic exam. They most likely originate from which artery on the same side?

• A. Left internal carotid
• B. Right ophthalmic
• C. Abdominal aorta
• D. Popliteal artery

Answer: (B)

Cholesterol emboli seen in the retina (Hollenhorst plaques) come from atherosclerotic plaques in large arteries and travel into the retinal vessels via the ophthalmic artery. The ophthalmic artery is the first major branch of the internal carotid and supplies the eye. Therefore, when these plaques are observed in the fundus on one side, the most likely source is the ipsilateral carotid system feeding that eye, specifically the right ophthalmic artery for a right-sided finding. The other arteries listed are less directly linked to delivering emboli to the retina on a specific side.