LIPEMIA RETINALIS IN METABOLIC SYNDROME

Abstract

A 19-year-old female with a history of pure gonadal dysgenesis and metabolic syndrome was undergoing regular diabetic eye screening. Recent clinical examination revealed bilateral creamy-white retinal vessels, in keeping with the features of lipemia retinalis (LR). Optical coherence tomography (OCT) images also show hyperreflective deposits accumulated in the dilated retinal vessels with a shadowing effect. Further investigations showed a total serum cholesterol level of 24.2 mmol/L and an unreadable triglyceride level due to a lipemic blood sample. Her medications were increased to T. atorvastatin 40 mg at night and T. ezetimibe 10 mg once daily by her physician. Unfortunately, she developed acute pancreatitis secondary to diabetic ketoacidosis with hypertriglyceridemia three months after the diagnosis of LR. LR is a clinical indication of a very high triglyceride level when laboratory testing is not possible. The high comorbidities associated with hypertriglyceridemia and diabetes may warrant close monitoring for cardiovascular disease and life-threatening pancreatitis.