![]() ![]() Signs of lipemia retinalis include peripheral vessels that appear creamy and thin later in the disease, the vessels in the posterior pole assume a creamy color and in the most advanced stage, the fundus becomes salmon-colored, with creamy arteries and veins. Ocular exam may reveal corneal arcus and dilated fundoscopic exam is necessary for the diagnosis and staging of lipemia retinalis. Skin exam should look for eruptive xanthomas. The cardiovascular exam should include heart sounds, carotid or renal bruits, and peripheral pulses. Vital signs should focus on artherosclerotic changes. ![]() The physical exam on a patient with lipemia retinalis includes vital signs, cardiovascular exam, integumentary exam and dilated fundoscopy. The familial disorders include ApoC-II deficiency, endogenous circulating LPL inhibitor, and LPL deficiency. Hypertriglyceridemia occurs as a primary familial disorder or secondary to other diseases. There may be a family history of lipid abnormalities. Lipemia retinalis is diagnosed based upon its clinical appearance on dilated fundoscopic exam and coexistent hypertriglyceridemia. Reduction and control of serum triglyceride levels will prevent lipemia retinalis from developing. Correction of the lipid levels may reverse the abnormal findings within one week.Strict adherence to a low-fat diet without breast milk supplementation may be effective in treating infants with severe lipemia retinalis associated with very high serum triglyceride levels. The clinical appearance is graded accordingly as early, moderate, or marked (Stages I-III, respectively). At triglyceride levels of 2500–3499 mg/dL, the peripheral vessels appear creamy and thin at levels of 3500–5000 mg/dL, the vessels in the posterior pole assume a creamy color and at levels exceeding 5000 mg/dL, the fundus becomes salmon-colored, with creamy arteries and veins that can be distinguished by caliber only. The early signs of lipemia retinalis occur in the peripheral retina, and as triglyceride levels increase, they spread to the posterior pole. ![]() Hyperlipidemia without accompanying hypertriglyceridemia does not present this clinical picture. The ocular findings result from light scatter induced by the triglyceride-laden chylomicrons in the plasma. It serves as a vital clinical sign of hypertriglyceridemia because acute triglyceride elevations may be asymptomatic at first, delaying treatment of a potentially lethal metabolic disorder as elevations of this magnitude may lead to cardiovascular consequences including heart attack or stroke. Lipemia retinalis is an ocular finding associated with elevated plasma levels of triglycerides. However, genotype–phenotype correlations have not been established, as there is no established association between the nature or location of the mutation, age at diagnosis, lipid levels, and severity of symptoms. Lipemia retinalis is commonly associated with high triglyceride levels in hyperlipoproteinemias types 1, 3, 4, and 5 with different underlying causes, and chromosome microarray and lipid gene sequencing may demonstrate a homozygous lipoprotein lipase gene coding mutation. Diabetes and hypertension was associated in 14% and 31.3% of cases respectively. Individuals with severe hypertriglyceridemia tended to be men (75.3%), non-Hispanic whites (70.1%), and aged 40-59 years (58.5%). Multiple genes responsible for triglyceride metabolism have been identified as causing the serum triglyceride levels to see characteristic retinal vasculature abnormalities. Based on the National Health and Nutrition Examination Survey from 20, approximately 1.7% of the total US population, or 3.4 million Americans, were estimated to have severe hypertriglyceridemia (500 to 2,000 mg/dl). Lipemia Retinalis, is caused by hypertriglyceridemia with serum triglyceride levels typically greater than 1000 mg/dl. Lipemia Retinalis is a rare manifestation of hypertriglyceridemia manifested by abnormal appearance of the retinal arteries and veins, and occasionally the entire fundus. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |