Background: Lipaemia retinalis is a rarely described ocular manifestation of hyperlipidemia. We report on a female patient with visual loss and visual field defects associated with lipaemia retinalis due to a metabolic syndrome.
Patient: A 45-year-old female patient presented with bilateral slowly progressing visual loss. Additionally, there were eruptive xanthomatas all over the body. Visual acuity measured 0.2 in both eyes. There was a bilateral creamy discoloration of retinal vessels with a salmon-colored fundus. The peripheral visual field was reduced. Laboratory findings indicated a severe mixed hyperlipidemia (triglyceride 11,694 mg/dl, cholesterol 1724 mg/dl). Immediately initiated therapy to normalize the metabolism resulted in improvement of clinical symptoms.
Conclusion: Lipaemia retinalis is an useful clinical indicator for triglyceridemia. Persistent lipaemia retinalis may lead to visual loss and visual field defects and may be a sign of severe metabolic disturbances. To prevent cardiovascular complications immediate treatment is necessary.