Lipemia Retinalis in a Patient with Familial Hypertriglyceridemia

Abstract

A 45-year-old female with a history of hypertension presented with complaints of intermittent vision loss and blurred vision. Clinical examination revealed diffuse retinal whitening in the peripapillary area with multiple visible emboli in the first- and second-order arteries. The patient's retinal findings were keeping within features of lipemia retinalis, and serum lipids were ordered which returned a triglyceride level of 1504 mg/dL. The patient was referred to primary care for vascular risk factor management and potential genetic testing. Ocular signs of hypertriglyceridemia manifest as lipemia retinalis, characterized by white vascular lesions and retinal lipid infiltration. The high comorbidity of hypertriglyceridemia and hypertension may warrant close monitoring hypertensive complications such as hypertensive retinopathy.

Keywords: Hypertriglycerdemia; Lipemia retinalis; Retina.

Figure 1:

A 45-year-old woman with familial hypertriglyceridemia. (a) Widefield color fundus of the right eye illustrates diffuse retinal whitening with multiple visible emboli in the first- and second-order arteries. (b) Widefield color fundus of the left eye demonstrates similar peripheral retinal whitening with multiple visible emboli as well as arterial venous nicking.

Figure 2:

A 45-year-old woman with familial hypertriglyceridemia. (a) Widefield intravenous fluorescein angiography of the right eye demonstrates arterial filling delay and pattern of hypofluorescence consistent with capillary non-perfusion. (b) Widefield intravenous fluorescein angiography of the left eye displays similar arterial filling delay and hypofluorescence pattern.