Bilateral Enlargement of the Foveal Avascular Zone on Optical Coherence Tomography Angiography Associated With Cocaine Use

Cocaine is a well-known cause of vascular injury and secondary end-organ damage. The presented case demonstrates retinal vascular abnormalities associated with a history of cocaine use in the absence of other retinal disease. A 61-year-old Latino man was referred for evaluation of gradual worsening near visual acuity and an inability to find a satisfactory refraction. His best-corrected visual acuity was 20/30 in each eye. Optical coherence tomography demonstrated bilateral inner retinal atrophy with disruption of the inner retinal layers and effacement of the foveal contour ( Figure 1 ). These changes spanned multiple vascular distributions. Fluorescein angiogram showed an enlarged foveal ...
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