[Fish eye disease]. / Fischaugenkrankheit.

A 67-year-old man complained of impaired vision at night for several months. He was known to have arcus senilis (arcus lipoides corneae) since aged 21 years. For the last 20 years both corneas had become progressively more cloudy. His mother was said to have had similar eye changes. Ophthalmological examination discovered no abnormality other than marked corneal dystrophy with hardly separable arcus senilis. General physical examination was normal. Total cholesterol and triglyceride levels in serum were within normal limits, but serum concentration of high density lipoprotein (HDL) cholesterol (8 mg/dl) was reduced as were, within the high density lipoprotein fraction, the concentrations of triglyceride (4 mg/dl), phospholipids (38 mg/dl), the proportion of cholesterol esters (31%), and the cholesterol-esterification rate (51 nmol/ml . h). The HDL-associated activity of lecithin-cholesterol-acetyltransferase activity was scarcely measurable (0.9 nmol/ml . h). The signs in this case (cloudy cornea, marked decrease in serum HDL cholesterol concentration without premature arteriosclerosis) are typical of fish eye disease.

Lipoprotein (a): a risk factor for retinal vascular occlusion.

The protein moiety of lipoprotein (a) consists of apoB-100 and apolipoprotein (a). Lipoprotein (a) is an independent risk factor for premature atherosclerosis. Apolipoprotein (a) and plasminogen are structurally homologous. Through interference with the fibrinolytic system, lipoprotein (a) may act as a thrombogenic factor. In the present study, we determined lipoprotein (a) concentrations in 84 patients (60 men and 24 women) with retinal vascular occlusion (RVO) and in 2 groups of healthy volunteers (n = 40 and 46). In all, 29% of the patients had Lp (a) levels of above 300 mg/l. In the two reference groups, only 10% and 9% of the subjects exceeded this level. According to the chi-square test, the association between Lp (a) levels and RVO was significant. Lp (a) concentrations did not differ between patients with arterial occlusion and those with venous occlusion. No difference in the total cholesterol, triglyceride, or LDL-cholesterol values was observed between patients and controls. We therefore conclude that Lp (a) represents an independent risk factor for RVO.