Background: To our knowledge, isolated retinal cholesterol embolism with central or branch retinal artery occlusion post carotid angioplasty and stenting (CAS) leading to permanent visual loss, has not been previously described.
Case Report: We present a case of monocular retinal cholesterol embolism and central retinal artery occlusion leading to permanent visual acuity loss, occurring 30 hours after performing ipsilateral carotid angioplasty and stenting for high grade stenosis. Retinal cholesterol emboli, otherwise referred to as Hollenhorst plaques, were identified by fundoscopy with changes of retinal ischemia after the patient complained of post procedure visual acuity change.
Conclusions: Identification factors predisposing patients susceptible to embolic risk and judicious selection of instrumentation across the vulnerable plaque during the procedure are important considerations in preventing this complication.

Keywords: occlusion, central retinal artery, cholesterol emboli, carotid artery angioplasty and stenting