72 yo in the neurology clinic. What study will you order next?

A Hollenhorst plaque is a cholesterol embolus that is seen in a blood vessel of the retina.
It is usually seen when a physician performs ophthalmoscopy, during which a plaque will appear bright, refractile, and yellow. It is caused by an embolus lodged within the retinal vessel that originated from an atheromatous plaque in a more proximal (upstream) vessel, usually the internal carotid artery. It is often an indication of a previous ischemic episode in the eye and is a sign of severe atherosclerosis. The most important step in management is to identify and treat the originating plaque to prevent further embolization.
Majority of emboli arise from the carotid bifurcation- next study-duplex US of the neck
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