This previously healthy 38YO male was referred for asymptomatic retinal findings. Vision was 20/25 OD and 20/20 OS. Optos color RG imaging shows symmetric, creamy-colored blood vessels bilaterally. Emergent bloodwork showed total cholesterol 1093 mg/dL, triglycerides 9644 mg/dL, and HDL 4 mg/dL. He was immediately referred to his PCP for emergent medical management. He was immediately lost to follow up.
Learning Points:
Lipemia retinalis is a rare retinal manifestation of severe hypertriglyceridemia, characterized by creamy white discoloration of the retinal vasculature. In severe cases, the fundus can turn salmon-colored. Patients are asymptomatic, and vision is normal. However, they are at obvious cardiovascular risk without systemic treatment.
