A Potential Pathway for Managing Diabetic Patients with Arterial Emboli Detected by Retinal Screening

Objective: The aim was to review a pathway of care for diabetic patients found to have retinal artery emboli detected by retinal screening. Design: This was a retrospective review of a pathway agreed in 2001 by a multidisciplinary team. Materials and methods: The prospectively collected Gloucestershire Diabetic Retinal Screening Programme database was reviewed; patients sent for carotid duplex imaging underwent review of their scan results and their casenotes. Results: The prevalence of retinal emboli was 214 out of 25,299 diabetic patients who had retinal screening (0.85%). Some 200 diabetic patients underwent carotid duplex imaging; 23 had ipsilateral and 2 had contralateral carotid stenosis >70%. Of these, ten patients underwent carotid endarterectomy without any major morbidity. Conculsions: A pathway was established for the small number of patients with retinal emboli, and could be tested in other populations. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.