Lipid Metabolic Disorder with Varied Clinical Manifestations

Published:October 13, 2021DOI:
      A 39-year-old male with type 2 diabetes visited the Ophthalmology Department with blurred vision in both eyes for the past 10 days. Eventually, we assumed that diabetes-associated refractive changes were responsible for the patient's visual disturbance. However, all visible retinal arteries and veins appeared unusually creamy white (Figure 1). He reported self-injecting himself with insulin 2 days before his symptoms appeared, as prescribed by his family doctor, in addition to taking oral hypoglycemic agents. He also took carvedilol (a beta-blocker) for hypertension. Moreover, he reported rashes on his neck and both arms a day after he started taking carvedilol.
      Figure 1
      Figure 1Fundus photograph showing unusual creamy white retinal arteries and veins.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Koopal C
        • Bemelmans R
        • Marais AD
        • Visseren FL.
        Severe hypertriglyceridaemia and pancreatitis in a patient with lipoprotein lipase deficiency based on mutations in lipoprotein lipase (LPL) and apolipoprotein A5 (APOA5) genes.
        BMJ Case Rep. 2019; 12e228199
        • Kashif M
        • Kumar H
        • Khaja M.
        An unusual presentation of eruptive xanthoma: a case report and literature review.
        Medicine (Baltimore). 2016; 95: e4866
        • Henning JS
        • Fazio MG.
        Yellowish papules on a middle-aged man. Eruptive xanthoma.
        Am Fam Physician. 2011; 83: 73-74
        • Leaf DA.
        Chylomicronemia and the chylomicronemia syndrome: a practical approach to management.
        Am J Med. 2008; 121: 10-12
        • Hinkle JW
        • Relhan N
        • Flynn Jr, HW.
        Lipemia retinalis, macular edema, and vision loss in a diabetic patient with a history of type IV hypertriglyceridemia and pancreatitis.
        Case Rep Ophthalmol. 2018; 9: 425-430
        • Rymarz E
        • Matysik-Woźniak A
        • Baltaziak L
        • Prystupa A
        • Sak J
        • Grzybowski A.
        Lipemia retinalis - an unusual cause of visual acuity deterioration.
        Med Sci Monit. 2012; 18: CS72-CS75