To the Editor.—I read with interest Dr. Richard Fine's article in The Journal (Amer J Dis Child 115:238-331 [March] 1968). I would like to make some comments with regard to the author's statement: "Retinal changes have not been previously described in patients with GSD Type I."
Newer mentioned Von Gierke's disease among conditions in which lipemia retinalis occurs. To quote from his book1: "Lipemia retinalis occurs most commonly in diabetic acidosis, usually in growth onset diabetes. It may occur also in essential familial hyperlipidemia, secondary hyperlipidemias of the nephrotic syndrome, pancreatitis, Von Gierke's disease, or other conditions with increased triglyceride concentration of the blood."
Dr. Fine and his associates described: "Multiple bilateral symmetrical, yellowish, nonelevated discrete paramacular lesions" in the occular fundi of their cases and found them most striking in patients with the highest serum triglyceride levels. These changes are not consistent with the classical description of