Dear Editor,
In the October 2021 issue of the Turkish Journal of Ophthalmology, Öztürk et al.1 presented an interesting case of lipemia retinalis (LR) in a Turkish preterm infant diagnosed incidentally after laser photocoagulation therapy for retinopathy of prematurity. We believe that Öztürk et al.1 should consider prenatally acquired human immunodeficiency virus (HIV) infection in the case in question, based on the following point. Globally, HIV infection is still a major health threat. Though HIV/AIDS cases in Turkey were recorded at a level of zero in 2020 according to World Bank data, which is compiled from officially recognized sources,2 it was previously reported that the epidemiologic profile of HIV-infected individuals is changing in Turkey.3 Most neonatal HIV infections are the result of vertical transmission.4 The neonatal population has weaker immunity compared to adults; therefore, if they contract HIV infection, they are at greater risk of rapid disease progression, with significant morbidity and mortality rates.4 Among emerging HIV-associated complications, hyperlipidemia is increasingly recognized. A substantial number of HIV-infected children were found to have persistent elevation of serum lipid levels, potentially putting them at risk for life-threatening events.5 Among these events, cases of LR have been reported only among HIV-positive adults.6 Accordingly, we believe that an underlying HIV infection should be seriously considered in the case in question, and arranging for CD4 count and viral load estimations and fourth-generation antigen/antibody immunoassays in the mother and her studied preterm infant would be warranted. If these tests were to disclose HIV positivity, the presented case could be considered a novel case report of HIV-associated neonatal LR.
Peer-review: Externally peer reviewed.
Financial Disclosure: The author declared that this study received no financial support.