Lipemia retinalis - an unusual cause of visual acuity deterioration

Abstract

Background: Hyperlipidemia is an identified factor of premature vessel atherosclerosis. Lipemia retinalis is an unusual retinal manifestation of hyperlipidemia and is thought to be directly correlated with the serum triglyceride level.

Case report: This paper discusses the case of a 55-year-old patient with lipemia retinalis, which deteriorated his visual acuity. The patient had an extremely high serum cholesterol level (1053 mg/dl) and a very high level of triglycerides (1513 mg/dl). The normalization of serum lipids, reversion of retinal vessels alterations and visual acuity improvement was achieved after an intensive statin lipid-lowering therapy. Pathological changes of the patient's retina, connected with lipemia retinalis, disappeared completely.

Conclusions: Hyperlipidemia can cause lipemia retinalis, which is characterized by the hyperlipidemic vascular lesions-whitish color of vessels, lipid infiltration into the retina and decrease of visual acuity. The lipid-lowering therapy may lead to the normalization of the appearance of the fundus and restore the visual acuity.

Figure 1

The right eye fundus with signs of lipemia retinalis (optic disc and nasal part of retina). Characteristic whitish vessels are visible. It is difficult to distinguish the arteries from the veins.

Figure 2

The left eye fundus with signs of lipemia retinalis (optic disc and a part of macula). Characteristic whitish vessels are visible. It is difficult to distinguish the arteries from the veins.

Figure 3

The right eye fundus after treatment. The retinal vessels abnormalities returned to normal. Nevertheless, the age-related macular degenerations remained (a big scar in the macula).

Figure 4

The left eye fundus after treatment. The retinal vessels abnormalities returned to normal. Nevertheless, the age-related macular degenerations remained (retinal pigment defects, drusen).