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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.

Jon Ortiz de Salido Menchaca, Hospital de Laredo, Servicio de Urgencias. Cantabria, España.

orcid_id14.png https://orcid.org/0000-0002-0100-405X

Manuel Antonio Tazón Varela, Hospital de Laredo, Servicio de Urgencias, Cantabria, España, 2 Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Área Transversal- Grupo Salud Comunitaria. Cantabria, España

orcid_id14.png https://orcid.org/0000-0001-5460-7877

David de la Hera Vegas, Hospital de Laredo, Servicio de Oftalmología, Cantabria, España

orcid_id14.png https://orcid.org/0000-0001-8898-0282

Rosa Herreras Martínez, Hospital Universitario Marqués de Valdecilla, Servicio de Medicina Interna, Cantabria, España

orcid_id14.png https://orcid.org/0000-0003-4337-2130

Sergio Andrés Álvarez Agudelo, Hospital de Laredo, Servicio de Urgencias. Cantabria, España

orcid_id14.png https://orcid.org/0000-0002-2294-3160

Nuria Arencibia Hernández, Hospital de Laredo, Servicio de Urgencias. Cantabria, España.

orcid_id14.png https://orcid.org/0000-0003-0806-0297

Ortiz de Salido Menchaca, J., Tazón Varela, M. A., de la Hera Vegas, D., Herreras Martínez, R., Álvarez Agudelo, S. A., & Arencibia Hernández, N. (2024). Retinal lipemia as expression of hyperchylomicronemia syndrome. Colombia Medica, 52(1), e7024059. Retrieved from https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4059 (Original work published April 4, 2021)

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Received 2019-11-28
Accepted 2021-03-25
Published 2024-05-09