J Korean Ophthalmol Soc.  2014 Apr;55(4):623-627.

Lipemia Retinalis in a Patient with Diabetic Retinopathy

• Choi SW
• Kim YC

Abstract

PURPOSE
To report a case of lipemia retinalis in a patient with diabetes.
CASE SUMMARY
A 27-year-old female with type 2 diabetes visited our clinic with visual disturbance in her left eye while being followed up from a pars plana vitrectomy in her right eye for proliferative diabetic retinopathy. On fundus examination of both eyes, the retinal vessels were creamy white and the retinal veins were undistinguishable from the retinal arteries. The serum triglyceride level was 2,676 mg/dL. The patient was asymptomatic except for visual impairment due to vitreous hemorrhage in her left eye. The patient was diagnosed with lipemia retinalis and chylomicronemia syndrome. After controlling the triglyceride level, funduscopic findings in the both eyes were improved. However, the visual acuity in her right eye remained unchanged.
CONCLUSIONS
Lipemia retinalis can be a sign of a systemic condition although it may not affect visual acuity. Fundus examination may be a useful tool in the early diagnosis of hyperlipidemia.

Keyword

Chylomicronemia syndrome; Lipemia retinalis; Triglyceride

MeSH Terms

Adult
Diabetic Retinopathy*
Early Diagnosis
Female
Humans
Hyperlipidemias*
Retinal Artery
Retinal Vein
Retinal Vessels
Triglycerides
Vision Disorders
Visual Acuity
Vitrectomy
Vitreous Hemorrhage

Figure

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  Figure 1. (A) Fundus photograph shows preretinal hemorrhage involving the macula. (B) Fundus photograph after pars plana vitrectomy.

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  Figure 2. Fundus photography, fluorescein angiogram and optical coherence tomography before (A, B, C) and after (D, E) resolution of elevated triglyceride. (A) Retinal vessels are orange-colored and arterioles and venules are indistinguishable. (B) Fluorescein angiogram (left) shows tortuous and dilated large retinal vessels without leakage. Optical coherence tomography (right) reveals normal retinal thickness with foveal depression. (C) Vitreous hemorrhage and preretinal hemorrhage with suspected lipid materials were seen. (D, E) In both eyes retinal vessels have recovered their own colors.

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  Figure 3. (A) A blood specimen was lipemic with a triglyceride concentration of 2,676 mg/dL. (B) The blood specimen with a triglyceride concentration of 425.1 mg/dL was less lipemic than (A).

Reference

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