Cocaine-induced central retinal artery occlusion

Author: Yassine Moursli (Morocco)

Co-authors: kaoutar sidki, khalid hallaji, adil mchachi, leila benhmidoune, rachid rayad, mohamed elbelhadji

Purpose

We describe a rare case of central retinal artery occlusion after intranasal cocaine insufflation.

Setting/Venue

Adults ophthalmology department, 20 August Hospital, UHC Ibn Rochd, University of Hassan II, Casablanca, Morocco

Methods

A 35-year-old male presented with a sudden loss of vision in the right eye after intranasal cocaine insufflation. He was an occasional user of cocaine and reported using it for 72 hours previously

Results

On examination, visual acuities were hand movement in the right eye and 10/10 in the left eye. Anterior segment examination was normal and intraocular pressures were 16 mmHg in both eyes. Fundus examination showed a diffuse retinal edema with macular cherry-red spot. The retinal vasculature was otherwise normal. A fundus fluorescein angiography was performed which demonstrated an absence of flow in the central retinal artery. Extensive blood tests were unhelpful; these included an echocardiogram, full blood count, erythrocyte sedimentation rate and electrolytes. The patient was managed with manual massage of the eye, fast intravenous mannitol 10% (500 ml in 20 minutes), followed by oral acetazolamide (500 mg) three times a day. There was no improvement in visual acuity

Conlusions

Cocaine abuse is dangerous and can cause devastating complications leading to blindness or even death.

Financial Disclosure

no financial relations