Purpose: To report a case of symptomatic multiple retinal emboli during a carotid Doppler ultrasonography (CDU) procedure.
Methods: Case report documented with clinical records, fundus photography, optical coherence tomography angiography of the retina, and computed tomography angiography of the supraaortic vessels.
Results: A 60-year-old male patient presented to the emergency department with sudden vision loss in the left eye and pain in the left upper eyelid noticed during a CDU procedure. On the left eye, the best-corrected visual acuity was 20/200, and fundus observation revealed retinal arteriolar attenuation, retinal whitening with cherry point, and multiple intraarterial emboli in all arcades of the central retinal artery. Computed tomography angiography of the supraaortic vessels revealed an absence of filling throughout the cervical, petrous, and cavernous segment of the left internal carotid artery, resuming only in the ophthalmic segment and an important stenosis of the left external carotid artery. He had no indication to be submitted to left carotid endarterectomy and began ocular massage and oral anticoagulant. Four months later, ptosis was no longer present, best-corrected visual acuity improved to 20/20 with a residual scotoma, and emboli disappeared on fundus photography.
Conclusion: Embolic occlusion of retinal arteries may be an extremely rare but serious complication associated with CDU, and patients and clinicians should be aware of it.