Lipaemia retinalis (LR) also spelled as Lipemia retinalis is an

eye disease This is a partial list of human eye diseases and disorders. The World Health Organization publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ICD-10. ...

caused by high amounts of

triglyceride A triglyceride (TG, triacylglycerol, TAG, or triacylglyceride) is an ester derived from glycerol and three fatty acids (from ''tri-'' and ''glyceride''). Triglycerides are the main constituents of body fat in humans and other vertebrates, as w ...

s in the

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

(

hypertriglyceridemia Hypertriglyceridemia is the presence of high amounts of triglycerides in the blood. Triglycerides are the most abundant fatty molecule in most organisms. Hypertriglyceridemia occurs in various physiologic conditions and in various diseases, and h ...

) or

Lipoprotein lipase deficiency Lipoprotein lipase deficiency is a genetic disorder in which a person has a defective gene for lipoprotein lipase, which leads to very high triglycerides, which in turn causes stomach pain and deposits of fat under the skin, and which can lead t ...

(chylomicronemia). In this condition the retinal arteries and veins, and occasionally the entire fundus shows creamy-white to salmon red discoloration.

Description

Lipaemia retinalis is a retinal disease caused by hypertriglyceridemia or chylomicronemia. Depending on plasma triglyceride level, the

retina The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which then ...

l arteries, veins or occasionally the entire fundus may show creamy-white to salmon red discoloration. In primary hyperlipidaemia, LR occurs only in patients with increased

chylomicron Chylomicrons (from the Greek χυλός, chylos, meaning ''juice'' (of plants or animals), and micron, meaning ''small particle''), also known as ultra low-density lipoproteins (ULDL), are lipoprotein particles that consist of triglycerides (85 ...

levels. Lipaemia retinalis occurs commonly with familial hypertriglyceridaemia, and rarely with combined hypertriglyceridaemia. Although serum triglyceride levels above 1000 mg / dL can cause eye symptoms such as

xanthoma A xanthoma (pl. xanthomas or xanthomata) (condition: xanthomatosis) is a deposition of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states. They are cutaneous manifestations of lipidosis in which lip ...

xanthelasma Xanthelasma is a sharply demarcated yellowish deposit of cholesterol underneath the skin. It usually occurs on or around the eyelids (''xanthelasma palpebrarum'', abbreviated XP). While they are neither harmful to the skin nor painful, these mino ...

and

arcus senilis Arcus senilis (AS), also known as gerontoxon, arcus lipoides, arcus corneae, corneal arcus, arcus adiposus, or arcus cornealis, are rings in the peripheral cornea. It‘s usually caused by cholesterol deposits, so it may be a sign of high choleste ...

, lipaemia retinalis is most commonly seen when the triglyceride level is above 1500 mg / dL. Changes in fundus are more pronounced when triglyceride levels exceed 2,500 mg / dL. According to Brunzell and Bierman, lipaemia retinalis occurs in 23% of patients with chylomicronaemia and they says it may be considered as a rare disease only because of lack of routine fundoscopic examination.

Signs and symptoms

In early stage of lipaemia retinalis, creamy-white discoloration of retinal blood vessels occurs and in extreme cases the fundus become salmon red colour. Retinal changes occur in the peripheral vessels gradually progress to entire fundus. Symptoms are caused by an increase in the level of chylomicron in the retinal circulation. Though

visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...

is not affected,

electroretinogram Electroretinography measures the electrical responses of various cell types in the retina, including the photoreceptors ( rods and cones), inner retinal cells ( bipolar and amacrine cells), and the ganglion cells. Electrodes are placed on the ...

amplitude may be decreased. Since acute increase in triglyceride may be asymptomatic at first, retinal signs of LR are an important clinical sign of hypertriglyceridemia.

Grading

Vinger and Sachs classified lipaemia retinalis into three grades. Early lipaemia retinalis with creamy white discoloration of peripheral retinal vessels is classified as Grade 1. When the discoloration extends towards optic disc, it is graded as Grade 2 and when retina becomes salmon colored it is classified as Grade 3.

Treatment

When the serum triglyceride is under control by proper dietary control and or

insulin Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the ''INS'' gene. It is considered to be the main anabolic hormone of the body. It regulates the metabolism o ...

, the changes in the retina and

changes return to normal.

History

In 1880, Heyl first described Lipaemia retinalis and in 1970 Vinger and Sachs introduced a grading system to describe it's stages.

Other animals

Increase in serum triglyceride can cause lipaemia retinalis in cats also.

References

{{DEFAULTSORT:Lipaemia retinalis Triglycerides Lipid metabolism disorders Disorders of choroid and retina