Lipemia Retinalis

Lipemia Retinalis
SYMPTOMS Typically asymptomatic
SIGNS Salmon/pink colored retinal arteries and arterioles, veins and venules, and capillaries.The entire fundus can also have a salmon/pink color as well
WORK-UP Pupils, EOMs, Full eye exam with dilated retinal exam, OCT analysis of the macula, OCT-Angiography, Fluorescein Angiography, Fundus photos
TREATMENT Refer to PCP/ER STAT in order to lower cholesterol
Needs to be monitored closely. There is no ocular treatment
FOLLOW-UP Once cholesterol is treated, patient should return for a follow-up. Retinal vasculature and/or the fundus goes back to normal quickly following control of cholesterol (can be within 1 week)
ETIOLOGY Light scatter of excessive triglycerides in the blood stream leads to the retinal vasculature and eventually the entire fundus having a salmon/pink color
DIFFERENTIAL DX Central retinal artery occlusion, Central retinal vein occlusion, Diffuse choroidal hemangioma
NOTES Associated with a high serum triglyceride level of >1000mg/dL (normal triglyceride level is < 150mg/dL)
Peripheral retinal vessels are affected first at triglyceride levels of 2500-3499 mg/dL
Retinal vessels in the posterior pole are affected at triglyceride levels of 3500-5000 mg/dL
The whole fundus develops a salmon/pink color at triglyceride levels of >5000 mg/dL (lipid leakage from damaged capillaries occur)
These patients have a high risk of cardiovascular disease and stroke
Lipemia Retinalis: Optos photo demonstrating salmon/pink colored retinal vasculature