Groß C., Bohl B., Herfurth S.

Department of Ophthalmology of the Ernst-Moritz-Arndt-University, Rubenowstr.2, 17487 Greifswald

Background: The Zieve-Syndrome marks the appearance of a hemolytic anaemia in conjunction with secondary hyperlipidemia in patients suffering from alcoholic toxic liver damage. So far no retinal changes have been reported due to the Zieve Syndrome.
Case report: A 44 year old diabetic introduced himself to the routine control to his ophthalmologist. It was known that he had a steatohepatitis due to an abuse of ethanol for years. For one month he had suffered from nausea and vomiting. The visual acuity was good on booth sides.(1,0 / 0,8) An extremely lipemic serum and a strong anaemia were present. The patient was referred to the internal department for further investigation. After excluding a gastrointestinal bleeding source the patient got two blood transfusions. The elevated cholesterol and triglyceride values in the serum could clearly be reduced by offering an inhibitor of cholesterin synthese enzym and a fibrat. Three weeks later the follow up examination revealed a regular blood flow and a degeneration of cotton wool-exsudates. One month later no pathological retinal findings were determined.
Conclusion: The retinal changes were caused by the combination of a strong anaemia and a hyperlipidemia. Those findings lead to further diagnostics. After treating the underlying metabolic disorder the retinal changes were completely reversible. No further impairment was observed.

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