Segmental arteriolar sheathing: A sign of retinal emboli

Abstract

In five patients with amaurosis fugax and visible retinal emboli, an additional finding was observed, consisting of focal arteriolar mural opacification. Typical atheromatous emboli were observed in each case, either in proximity to the vascular sheathing, or in the fellow eye. One case demonstrated the occurrence of an embolus, followed by focal progressive arteriolar opacification ensuing over the next few months. We believe that focal arteriolar sheathing is due to local arteriole wall reaction provoked at the time of embolus impaction, and that this sign in isolation is as useful a ‘calling card’ of embolic retinal disease as the appearance of the cholesterol embolus itself.

Key Words:

• retinal embolus
• arteriolar sheathing
• amaurosis fugax