Fat Emboli in the Retina Following Angiography

Loss of vision in one eye following carotid angiography has been documented in approximately 25 patients.¹⁻¹²It probably has occurred in many more. Sometimes the loss of vision is transient and at other times it is permanent. At times the fundus shows no abnormality or what is interpreted as vasospasm while at other times it shows embolic plugs in the arterial lumina. In the absence of pathologic confirmation these emboli have been variously interpreted as cholesterol crystals,¹³fat,¹⁴* air,¹⁵,¹¹dislodged atheromatous plaques,¹⁰and the injected contrast material.¹¹,¹² Moving "white spots" (seen with the ophthalmoscope) in retinal vessels occurring in atherosclerosis (not necessarily after angiography) have been interpreted as emboli and assumed to be masses of platelets and leukocytes.¹⁶,¹⁷One important case of uniocular blindness following carotid thromboendarterectomy has been examined histologically and interpreted as showing these platelet emboli.¹⁸ The present paper reports