title: Meaningful correlation between asymptomatic retinal arteriole emboli and calcified carotid plaque found on panoramic dental imaging of males with diabetes.
abstract: OBJECTIVE
  There is ongoing controversy with regard to the stability of calcified carotid artery plaques (CCAPs) seen in the bifurcation area on panoramic images (PIs). Therefore, we sought to evaluate the possibility of these plaques shedding emboli by observing their relationship with ipsilateral retinal emboli.
  
  
  METHODS
  The study group included 50 neurologically and visually asymptomatic males with diabetes, with PIs that incidentally demonstrated CCAPs (CCAP+) and contemporaneous digital retinal images that had been obtained for evaluation of diabetic retinopathy. The control group consisted of 50 males with diabetes who were matched for age and body mass index and had undergone both imaging studies and whose PIs were devoid of carotid plaques (CCAP-). The presence of retinal emboli was determined by two ophthalmologists blinded to the patients' medical histories, and the prevalence rates for the two groups were calculated.
  
  
  RESULTS
  The presence of asymptomatic retinal arteriolar emboli was found in the eye ipsilateral to the radiographically observed carotid atheroma in 10 of 50 (20%) of the patients in the CCAP+ group, compared with 2 of 50 (4%) in the CCAP- group, and this difference was statistically significant (Fisher's exact P < .03).
  
  
  CONCLUSIONS
  Some male patients with diabetes mellitus type II having calcified carotid artery atheromas in the bifurcation area, as visualized on PIs, may have significant sequelae as evidenced by retinal artery emboli.
authors.affiliation: Associate Chief of Staff and Director of Graduate Medical Education, Veterans Affairs Greater Los Angeles Healthcare System; Director of Quality Assurance, Hospital Dental Service, Ronald Reagan UCLA Medical Center; Professor-in-Residence of Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, CA, USA. Electronic address: Arthur.friedlander@va.gov.
authors.forename: Arthur H
authors.initials: AH
authors.lastname: Friedlander
authors.affiliation: Chief of Ophthalmology, Veterans Affairs Greater Los Angeles Healthcare System; Associate Clinical Professor at the UCLA Jules Stein Eye Institute, Los Angeles, CA, USA.
authors.forename: JoAnn A
authors.initials: JA
authors.lastname: Giaconi
authors.affiliation: Staff Ophthalmologist, Veterans Affairs Greater Los Angeles Healthcare System and Assistant Professor at the UCLA Jules Stein Eye Institute, Los Angeles, CA, USA.
authors.forename: Irena
authors.initials: I
authors.lastname: Tsui
authors.affiliation: Oral and Maxillofacial Surgery Research Fellow, Veterans Affairs, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: Nona
authors.initials: N
authors.lastname: Aghazadehsanai
authors.affiliation: Director of the Research Fellowship and Inpatient Oral and Maxillofacial Surgery, Veterans Affairs Greater Los Angeles Healthcare System; Instructor of Oral and Maxillofacial Surgery, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Tina I
authors.initials: TI
authors.lastname: Chang
authors.affiliation: Professor Emeritus, School of Dentistry, University of California, Los Angeles, CA, USA.
authors.forename: Neal R
authors.initials: NR
authors.lastname: Garrett
mesh_terms: D000368:Aged; D001160:Arterioles / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D048909:Diabetes Complications / Q000000981:diagnostic imaging*; D004617:Embolism / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D015356:Retinal Artery Occlusion / Q000000981:diagnostic imaging*