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Lipemia Retinalis: Hyperreflective Vascular Changes, Detected by Optical Coherence Tomography.

Lipemia Retinalis: Hyperreflective Vascular Changes Detected by Optical Coherence Tomography A 47-year-old Japanese man visited our clinic for his periodic checkup for diabetic retinopathy. His diabetes mellitus was being treated by a family doctor; however, his glycemic control was poor with HbA1c around 14%. He had no visual symptoms, and his visual acuity was 20 of 20 in both eyes. Ophthalmoscopy showed a creamy-white discoloration of all of the retinal vessels and salmon-colored appearance of the posterior pole of both eyes (Figure 1A). Optical coherence tomography revealed hyperreflective changes in the large retinal vessels and choriocapillaris, and hyperreflective dots in the inner retinal layer (Figure 1B). The fluorescein angiograms showed no remarkable changes. We suspected lipemia retinalis and performed blood examinations. The laboratory evaluations showed a remarkable elevation of the serum triglyceride level of 12,520 mg/ dL, and he was referred to the department of metabolism. Detailed laboratory examination detected the decreased lipoprotein lipase level of 28 ng/mL, and the familial lipoprotein lipase deficiency was suspected as the cause of hyperchylomicronemia. After the medical treatment, the serum triglyceride level decreased to 736 mg/dL, and