Reply to Letter to the Editor

Reply to Letter to the Editor re: “Lipemia Retinalis Diagnosed Incidentally After Laser Photocoagulation Treatment for Retinopathy of Prematurity”


  • Taylan Öztürk

Received Date: 13.12.2021 Accepted Date: 13.12.2021 Turk J Ophthalmol 2021;51(6):414-415 PMID: 34963274

Keywords: Lipemia retinalis, premature infant, HIV

Dear Editor,

We are thankful for the opportunity to respond to the issue raised in the letter to the editor that was recently directed to us. We would also like to thank the authors of the letter for their interest in our case report presenting a preterm infant with lipemia retinalis (LR) diagnosed incidentally after laser photocoagulation treatment for retinopathy of prematurity, and for taking their valuable time to express their concerns.1

In their letter, the authors rightly recommended a detailed study for prenatally acquired human immunodeficiency virus (HIV) infection for the presented case, as there may be a strong relationship between HIV infection and dyslipidemia. This association has been described previously in the scientific literature.2,3,4,5,6 Such publications have especially emphasized the potential association between lipid metabolism disorders and antiretroviral therapy with protease inhibitors or nucleoside reverse transcriptase inhibitors used in the medical treatment of patients with HIV infection. However, markedly elevated levels of total cholesterol, low-density lipoprotein, and triglyceride may be found in HIV patients related to the virus itself.5,6 In the presented case, we tested for blood-borne diseases including hepatitis B and C, as well as HIV just before laser photocoagulation therapy in the routine work-up done before interventions performed in the operating room, and the blood test for HIV infection resulted negative. However, the authors’ valuable insight should be heeded, and all infants diagnosed with LR should undergo testing for prenatally acquired HIV infection.

Peer-review: Externally peer reviewed.

Financial Disclosure: The author declared that this study received no financial support.

  1. Ozturk T, Karatas Yigitaslan E, Teke Kisa P, Onay H, Saatci AO. Lipemia Retinalis Diagnosed Incidentally After Laser Photocoagulation Treatment for Retinopathy of Prematurity. Turk J Ophthalmol. 2021;51:313-316.
  2. Mbuya W, Mwakyula I, Olomi W, Agrea P, Nicoli F, Ngatunga C, Mujwahuzi L, Mwanyika P, Chachage M. Altered Lipid Profiles and Vaccine Induced-Humoral Responses in Children Living With HIV on Antiretroviral Therapy in Tanzania. Front Cell Infect Microbiol. 2021;11:721-747.
  3. Chow CC, Birnbaum A, Janowicz M, Goldstein DA. Lipemia retinalis as a presenting feature of hypertriglyceridemia associated with protease inhibitors in human immunodeficiency virus-infected patients. Retin Cases Brief Rep. 2012;6:294-297.
  4. Jacobson DL, Williams P, Tassiopoulos K, Melvin A, Hazra R, Farley J. Clinical management and follow-up of hypercholesterolemia among perinatally HIV-infected children enrolled in the PACTG 219C study. J Acquir Immune Defic Syndr. 2011;57:413-420.
  5. van Genderen JG, Van den Hof M, de Boer CG, Jansen HPG, van Deventer SJH, Tsimikas S, Witztum JL, Kastelein JJP, Pajkrt D. Longitudinal Assessment of Lipoprotein(a) Levels in Perinatally HIV-Infected Children and Adolescents. Viruses. 2021;13:2067.
  6. Green ML. Evaluation and management of dyslipidemia in patients with HIV infection. J Gen Intern Med. 2002;17:797-810.