Retinal lipemia as expression of hyperchylomicronemia syndrome

Abstract

Case description:

Case of Lipemia Retinalis (Lipemia Retinalis  ) secondary to hyperchylomicronemia in a 40-year-old man with a history of total body irradiation and immunosuppressive treatment came to the hospital due to decreased visual acuity and abdominal pain.

Clinical findings:

Hyperchylomicronemia caused the development of acute pancreatitis and Lipemia Retinitis  . The last one is an infrequent ocular manifestation that reflects excessive triglyceride parameters in the organism (> 2.000 mg / dL). Lipemia Retinalis is the accumulation of chylomicrons in the retinal vessels, which gives them a white and creamy appearance in direct retinal ophthalmoscopy. The initial clinical suspicion of hyperchylomicronemia was based on the visualization of the supernatant in the analytical tube.

Treatment and result:

Without having definitive biochemical results, due to the need for special processing of the sample, lipid-lowering treatment and serum therapy were established after the ophthalmological confirmation of Lipemia Retinalis, with full recovery of visual acuity.

Clinical relevance:

Given the initial difficulty in this kind of patient to determine the accurate triglyceride levels, early visualization of milky-colored retinal vessels on a salmon-colored fundus can help develop an early clinical suspicion of severe hyperchylomicronemia and contribute to limit the severity of complications.