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Review
. 2024 Dec 22;13(24):7838.
doi: 10.3390/jcm13247838.

Retinal Vascular Complications in Cocaine Abuse: A Case Report and a Literature Review

Marta Armentano  1 , Ludovico Alisi  1 , Giacomo Visioli  1 , Maria Carmela Saturno  1 , Arianna Barba  1 , Alessio Speranzini  1 , Giuseppe Maria Albanese  1 , Magda Gharbiya  1   2 , Ludovico Iannetti  2
Affiliations
Review

Retinal Vascular Complications in Cocaine Abuse: A Case Report and a Literature Review

Marta Armentano et al. J Clin Med. .

Abstract

This comprehensive review examines the ocular vascular complications of cocaine use, focusing on its effects on retinal vasculature and inflammation. A rare case of bilateral frosted branch angiitis (FBA) in a 48-year-old man with a history of intranasal cocaine abuse is presented as an illustrative example to stimulate discussion. The case highlights severe retinal ischemia and vascular sheathing, with no identifiable infectious or autoimmune cause, ultimately complicated by systemic vascular events. Integrating this case with a review of the literature, we discuss cocaine's vasoconstrictive and immunomodulatory effects and their role in retinal pathology, including vasculitis, vascular occlusions, hemorrhages, and optic neuropathy. Although often a diagnosis of exclusion, and with rare and poorly understood consequences, this review underscores the importance of considering cocaine abuse in the differential diagnosis of complex retinal presentations.

Keywords: cocaine abuse; frosted branch angiitis; ocular complications; retinal hemorrhage; retinal ischemia; retinal pathology; retinal vasculitis; substance abuse; vascular occlusion; vitrectomy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Intraoperative images of the left eye retina. (A) The image highlights vascular sheathing typical of frosted branch angiitis (indicated by black arrows) and a pale optic disc. (B) A broader view shows vitreal hemorrhages (black asterisks), tractive macular membranes, optic disc pallor, and prominent vascular sheathing (black arrows).
Figure 2
Figure 2
Optical coherence tomography (OCT) scans of the left eye. The upper panels (A) show a dense fibrovascular tractive membrane at the posterior pole, causing significant distortion of the underlying retinal layers. The lower panels (B) present another section of the same scan at the level of the optic disc, demonstrating that the tractive membrane involves the entire posterior pole.
Figure 3
Figure 3
Slit lamp images showing paracentral corneal ulcer: white light (A); fluorescine coloring (B).
See this image and copyright information in PMC

References

    1. Phillips K., Luk A., Soor G.S., Abraham J.R., Leong S., Butany J. Cocaine cardiotoxicity: A review of the pathophysiology, pathology, and treatment options. Am. J. Cardiovasc. Drugs. 2009;9:177–196. doi: 10.1007/BF03256574. - DOI - PubMed
    1. Drake L.R., Scott P.J.H. DARK Classics in Chemical Neuroscience: Cocaine. ACS Chem. Neurosci. 2018;9:2358–2372. doi: 10.1021/acschemneuro.8b00117. - DOI - PMC - PubMed
    1. Bravo R.R., Faria A.C., Brito-Da-Costa A.M., Carmo H., Mladěnka P., da Silva D.D., Remião F., Researchers O.B.O.T.O. Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern. Toxins. 2022;14:278. doi: 10.3390/toxins14040278. - DOI - PMC - PubMed
    1. World Drug Report 2021 United Nations: Office on Drugs and Crime. [(accessed on 29 November 2024)]. Available online: https://www.unodc.org/unodc/en/data-and-analysis/wdr2021.html.
    1. Bachi K., Mani V., Jeyachandran D., Fayad Z.A., Goldstein R.Z., Alia-Klein N. Vascular disease in cocaine addiction. Atherosclerosis. 2017;262:154–162. doi: 10.1016/j.atherosclerosis.2017.03.019. - DOI - PMC - PubMed

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