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Colombia Médica
On-line version ISSN 1657-9534
Abstract
ORTIZ DE SALIDO-MENCHACA, Jon et al. Retinal lipemia as expression of hyperchylomicronemia syndrome. Colomb. Med. [online]. 2021, vol.52, n.1, e7024059. Epub Mar 30, 2021. ISSN 1657-9534. https://doi.org/10.25100/cm.v52i1.4059.
Case description:
Case of lipemia retinalis secondary to hyperchylomicronemia in a 40-year-old man with a history of total body irradiation and immunosuppressive treatment that was attended in this hospital due to decreased visual acuity and abdominal pain.
Clinical findings:
Hyperchylomicronemia caused the development of acute pancreatitis and lipemia retinalis. The latter is an infrequent ocular manifestation that reflects excessive triglyceride blood levels in the organism (>2,000 mg/dL). Lipemia retinalis is characterized by 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:
In the absence of definitive biochemical results, and owing to the need for special processing of the sample, lipid-lowering treatment and serum therapy were established after ophthalmological confirmation of lipemia retinalis, with subsequent full recovery of visual acuity.
Clinical relevance:
Given the initial difficulty to determine the accurate triglyceride levels in this kind of patient, early visualization of milky-colored retinal vessels on a salmon-colored eye fundus can help develop an early clinical suspicion of severe hyperchylomicronemia and contribute to limit the severity of complications.
Keywords : Visual Acuity; hyperlipemia; retina, hypertriglyceridemia; chemotherapy; adjuvant radiotherapy.