Background/purpose: To report a case of paracentral acute middle maculopathy in association with cocaine use.
Methods: This is a case report of a 26-year-old man presented with acute vision loss in the left eye following cocaine use.
Results: Fundus examination demonstrated faint retinal, whereas optical coherence tomography displayed hyperreflectivity predominantly in the middle retinal layers. Because of associated loss-of-consciousness and vision loss, a stroke work-up was initiated and ruled-out embolic and neurologic causes. The vision loss was attributed to paracentral acute middle maculopathy secondary to cocaine. The vision and retinal alterations on optical coherence tomography improved with observation.
Conclusion: This case demonstrates a potential unique etiology of paracentral acute middle maculopathy following exposure to cocaine. Paracentral acute middle maculopathy may occur in the setting of cocaine use. Optical coherence tomography evaluation with close surveillance can be helpful to identify the often subtle findings of paracentral acute middle maculopathy in cases of vision loss associated with illicit drug use.