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    Can You Guess June's Mystery Condition?

    Oculoplastics/Orbit, Retina/Vitreous

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    Make your diagnosis in the comments, and look for the answer in next month’s Blink.

    Fig. 1: Slit-lamp biomicroscopic examination showing temporal conjunctival sentinel vessels. Fig. 2: Gonioscopy revealing a vascularized pink mass. Figs. 3,4: Pathology images.

     

    Last Month’s Blink

    Lipemia Retinalis

    Written by Julia L. Xia, MD, and Jesse M. Smith, MD. Photos by Bianca Madrid. All are at the Sue Anschutz-Rodgers Eye Center, University of Colorado, Aurora.

    Figs. 1,2: Diffuse whitening of the retinal vessels. Figs. 3,4: Normal retinal vasculature.

    An asymptomatic 42-year-old woman presented for a rou tine eye exam and was found to have diffuse whitening of the retinal vessels in both eyes (Figs. 1, 2). The exam was other wise unre­markable; VA was 20/20 in both eyes, and OCT was normal. The patient had no significant med­ical or ocular history. However, laboratory testing revealed a triglyceride level higher than the upper limit of the test (1,100 mg/dL). She was started on atorvastatin, and her follow-up exam one month later showed normal retinal vasculature (Figs. 3, 4). Her vision remained unchanged from her previous visit.

    This case demonstrates an altered vascular appearance caused by light scatter from tri-glyceride-laden chylomicrons in the plasma. This phenomenon is typically associated with triglyceride levels greater than 1,000 mg/dL. These fundus findings can provide important insight into systemic comorbidities and may highlight opportunities for ophthalmologists to help diagnose potentially life-threatening systemic conditions.

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