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    June-2024-Blink_830

    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 routine 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.

    Read your colleagues’ discussion.

    BLINK SUBMISSIONS: Send us your ophthalmic image and its explanation in 150-250 words. E-mail to eyenet@aao.org, fax to 415-561-8575, or mail to EyeNet Magazine, 655 Beach Street, San Francisco, CA 94109. Please note that EyeNet reserves the right to edit Blink submissions.