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Requests for reprints should be addressed to Tatsuya Fujikawa, Department of General Internal Medicine, Mitoyo General Hospital, 708 Himehama Toyohama, Kanonji, Kagawa 769-1695, Japan.
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 1Fundus photograph showing unusual creamy white retinal arteries and veins.
Severe hypertriglyceridaemia and pancreatitis in a patient with lipoprotein lipase deficiency based on mutations in lipoprotein lipase (LPL) and apolipoprotein A5 (APOA5) genes.
