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Cocaine and choroidal infarction, revisiting the triangular sign of amalric
Shantan Reddy1, Darin R Goldman, Jean-Pierre Hubschman
1From the *New York University Medical Center, New York, New York; and †Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, California.
Purpose:
To describe a case of choroidal infarction as illustrated by the "triangular sign of Amalric" after cocaine inhalation.
Methods:
Observational case report.
Results:
A 52-year-old male presented with an acute loss of vision in his left eye immediately after cocaine inhalation. Color photography and fluorescein angiography revealed triangular areas of choroidal ischemia following the distribution of the posterior ciliary arteries.
Conclusion:
Cocaine-induced vasospasm, specifically of the distal short posterior ciliary arteries, may explain the triangular wedge-shaped choroidal infarcts in our patient. A thorough drug history may circumvent unnecessary and costly investigations in such cases.