Incidental finding of lipaemia retinalis on diabetic retinal screening
A 37-year-old female of South Asian origin was referred to our diabetes clinic for evaluation of an unusual finding during her retinal screening. Her retinal blood vessels appeared white in contrast to the normal pink-red colour. She had type I hyperlipidaemia, confirmed by genotype, and was recentl...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2021-10-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0051.xml |
| _version_ | 1818838598721470464 |
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| author | Punith Kempegowda Wentin Chen Eka Melson Annabelle Leong Prashant Amrelia Ateeq Syed |
| author_facet | Punith Kempegowda Wentin Chen Eka Melson Annabelle Leong Prashant Amrelia Ateeq Syed |
| author_sort | Punith Kempegowda |
| collection | DOAJ |
| description | A 37-year-old female of South Asian origin was referred to our diabetes clinic for evaluation of an unusual finding during her retinal screening. Her retinal blood vessels appeared white in contrast to the normal pink-red colour. She had type I hyperlipidaemia, confirmed by genotype, and was recently diagnosed with diabetes, secondary to pancreatic insufficiency, for which she had suboptimal control and multiple hospitalisations with recurrent pancreatitis. On examination, she had multiple naevi on her skin; the rest of the examination was unremarkable. The patient did not report any visual disturbances and had intact visual acuity. Investigations showed raised total cholesterol (12.5 mmol/L) and triglycerides (57.7 mmol/L). Following evaluation, the patient was diagnosed with lipaemia retinalis, secondary to type I hyperlipidaemia. The patient was managed conservatively to reduce the cholesterol and triglyceride burdens. However, therapies with orlistat, statin, fibrates and cholestyramine failed. Only a prudent diet, omega-3 fish oil, medium-chain triglycerides oil and glycaemic control optimised with insulin showed some improvements in her lipid profile. Unfortunately, this led her to becoming fat-soluble vitamin deficient; hence, she was treated with appropriate supplementation. She was also recently started on treatment with volanesorsen. Following this, her lipid parameters improved and lipaemia retinalis resolved. |
| first_indexed | 2024-12-19T03:40:57Z |
| format | Article |
| id | doaj.art-9f3f470d9a324756aa9d093035cfba35 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 |
| language | English |
| last_indexed | 2024-12-19T03:40:57Z |
| publishDate | 2021-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-9f3f470d9a324756aa9d093035cfba352022-12-21T20:37:15ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732021-10-01111610.1530/EDM-21-0051Incidental finding of lipaemia retinalis on diabetic retinal screeningPunith Kempegowda0Wentin Chen1Eka Melson2Annabelle Leong3Prashant Amrelia4Ateeq Syed5Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust Birmingham, Birmingham, UKMedical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; University Hospitals Birmingham NHS Foundation Trust Birmingham, Birmingham, UKHealth Education England West Midlands, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust Birmingham, Birmingham, UKUniversity Hospitals Birmingham NHS Foundation Trust Birmingham, Birmingham, UKA 37-year-old female of South Asian origin was referred to our diabetes clinic for evaluation of an unusual finding during her retinal screening. Her retinal blood vessels appeared white in contrast to the normal pink-red colour. She had type I hyperlipidaemia, confirmed by genotype, and was recently diagnosed with diabetes, secondary to pancreatic insufficiency, for which she had suboptimal control and multiple hospitalisations with recurrent pancreatitis. On examination, she had multiple naevi on her skin; the rest of the examination was unremarkable. The patient did not report any visual disturbances and had intact visual acuity. Investigations showed raised total cholesterol (12.5 mmol/L) and triglycerides (57.7 mmol/L). Following evaluation, the patient was diagnosed with lipaemia retinalis, secondary to type I hyperlipidaemia. The patient was managed conservatively to reduce the cholesterol and triglyceride burdens. However, therapies with orlistat, statin, fibrates and cholestyramine failed. Only a prudent diet, omega-3 fish oil, medium-chain triglycerides oil and glycaemic control optimised with insulin showed some improvements in her lipid profile. Unfortunately, this led her to becoming fat-soluble vitamin deficient; hence, she was treated with appropriate supplementation. She was also recently started on treatment with volanesorsen. Following this, her lipid parameters improved and lipaemia retinalis resolved.https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0051.xml |
| spellingShingle | Punith Kempegowda Wentin Chen Eka Melson Annabelle Leong Prashant Amrelia Ateeq Syed Incidental finding of lipaemia retinalis on diabetic retinal screening Endocrinology, Diabetes & Metabolism Case Reports |
| title | Incidental finding of lipaemia retinalis on diabetic retinal screening |
| title_full | Incidental finding of lipaemia retinalis on diabetic retinal screening |
| title_fullStr | Incidental finding of lipaemia retinalis on diabetic retinal screening |
| title_full_unstemmed | Incidental finding of lipaemia retinalis on diabetic retinal screening |
| title_short | Incidental finding of lipaemia retinalis on diabetic retinal screening |
| title_sort | incidental finding of lipaemia retinalis on diabetic retinal screening |
| url | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0051.xml |
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