Medicine · 3 authors, 1 centre
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A 39-year-old man with poorly controlled diabetes and severe hyperlipidemia developed persistent milky white discoloration of the anterior chamber (chylous aqueous humor) due to blood-aqueous barrier leakage allowing chylomicrons to enter the aqueous humor. Treatment with hypolipidemic, hypoglycemic, and local glucocorticoid therapy resolved the anterior chamber changes completely.
Laboratory tests revealed severe chylomicronemia, and the diagnosis was chylous aqueous humor. Treatment included systemic hypolipidemic and hypoglycemic therapy along with local glucocorticoids, after which the milky changes improved considerably and disappeared. A literature review identified only 3 prior reports, all in middle-aged men with poorly controlled diabetes and elevated triglycerides. Limitations include the single-patient design and that the precise mechanism of blood-aqueous barrier leakage remains unclear. The authors recommend ophthalmologists consider the ocular impact of hyperlipidemia.
