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

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.