Ophthalmological complications of the hypertriglyceridaemias

Hypertriglyceridaemia is an inappropriate elevation in plasma of chylomicrons, very low density lipoprotein, or both, functioning in the transport of exogenous and endogenous neutral fat respectively (lewis, 1976; Miller, 1979). The elevation may be due to rare genetically-determined defects or to a specific imbalance between triglyceride production and utilization, either secondary to or accentuated by other metabolic disturbances such as obesity or diabetes mellitus. Various surveys indicate that some degree of hypertriglyceridaemia affects more than 10 per cent of the adult population, with a male preponderance and a reduced expression during childhood (Lewis, 1976). Ophthalmological complications of hypertriglyceridaemia include eruptive and other forms of xanthomata including xanthelasmata, corneal arcus, lipaemia retinalis, effects on retinal blood flow, and lipid emboli affecting vision. The clinical features overlap those of hypercholesterolaemia and these features may lead to initial presentation and diagnosis of either disorder. Recognition of the underlying disorder is important since with treatment the incidence of major cardiovascular and other problems such as pancreatitis may be reduced, and with familial disorders other affected members may then be sought.