File number: 60170
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By Patrícia José Figueiredo Lopes
Co-author(s): Vítor Silva, Sara Vaz-Pereira
- Uploaded on Aug 6, 2020.
- Last modified by Caroline Bozell on Aug 6, 2020.
- Appears in
- lipemia retinalis, hyperlipidemia
- A 49-year-old female with history of insulin-dependent diabetes mellitus, hypertension and hyperlipidemia (managed with HMG-CoA reductase inhibitor plus lipid-lowering compound that inhibits intestinal cholesterol and phytosterol absorption) presented in a routine ophthalmology appointment. On examination, best-corrected visual acuity was 20/20 with an unremarkable anterior segment bilaterally. Funduscopic examination showed no signs of diabetic retinopathy. However, retinal vessels were creamish milky white, only distinguished by their size, suggesting lipemia retinalis (A, right eye; B, left eye). Triglyceride levels were 1500 mg/dL (normal range 0-150 mg/dL). Lipemia retinalis is a rare manifestation of hyperlipidemia but is a valuable tool for the diagnosis and treatment of this disease. The characteristic funduscopic findings include retinal blood vessels discoloration ranging from salmon pink to creamish white, depending on the level of plasma triglycerides. There are few reports about retinal changes in hypertriglyceridemia and all disclose triglyceride concentration exceeding 2,500 mg/dl.