Cholesterol emboli from vascular procedures most commonly lodge in which retinal artery, explaining acute vision loss in this scenario?

Cholesterol emboli from vascular procedures most commonly lodge in which retinal artery, explaining acute vision loss in this scenario?

• A. Central retinal artery
• B. Superior ophthalmic artery
• C. Anterior cerebral artery
• D. External carotid artery

Answer: (A)

Cholesterol emboli from vascular procedures tend to lodge in end-artery beds where there isn’t significant collateral flow, and in the retina the most common end-artery is the central retinal artery. Occlusion of this small vessel cuts off blood supply to the inner retinal layers, producing sudden, painless monocular vision loss. The central retinal artery originates from the ophthalmic artery, a branch of the internal carotid, making it the usual target for these emboli. Other choices don’t fit as well: the superior ophthalmic artery is upstream and larger, so emboli are less likely to consistently cause that specific pattern of retinal ischemia; the anterior cerebral artery and external carotid artery are not retinal end-arteries and aren’t the primary vessels supplying the retina, so emboli in those arteries wouldn’t explain the acute vision loss seen in this scenario.

Cholesterol emboli from vascular procedures tend to lodge in end-artery beds where there isn’t significant collateral flow, and in the retina the most common end-artery is the central retinal artery. Occlusion of this small vessel cuts off blood supply to the inner retinal layers, producing sudden, painless monocular vision loss. The central retinal artery originates from the ophthalmic artery, a branch of the internal carotid, making it the usual target for these emboli.

Other choices don’t fit as well: the superior ophthalmic artery is upstream and larger, so emboli are less likely to consistently cause that specific pattern of retinal ischemia; the anterior cerebral artery and external carotid artery are not retinal end-arteries and aren’t the primary vessels supplying the retina, so emboli in those arteries wouldn’t explain the acute vision loss seen in this scenario.