Solar Retinopathy Following Methamphetamine Abuse

Purpose: To report a case of solar retinopathy following methamphetamine (MA) abuse. Case report: A 37-years-old man was visited with sudden painless loss of vision in both eyes. He was addicted to methamphetamine for three years. He used MA at the day of admission. Excessive sun gazing (4 hours) took place due to using hallucinations secondary to the MA. Visual acuity was 15/400 Snellen chart in both eyes. In funduscopy, a bilateral round reddish plaque (0.5 DA) was detected at the center of the macula. A white central dot was located at aforementioned plaque. Foveal reflex was absent bilaterally. Optic nerve head (ONH) and peripheral retina were unremarkable. SD-OCT illustrated a distorted outer retina at the fovea with relatively spared inner retinal layers. Disruption of (EZ) and (IZ) was found at the damaged area, while the RPE was irregular. The size of disrupted area was around 800 microns in both eyes with a distinct border with the normal retina. A hyporeflective cavity was detected at the outer retina of both eyes located in the central fovea; Fluorescein Angiography (FA) demonstrated a window defect at the center of the fovea. Conclusion: Altered mental status following drug consumption makes the MA abusers vulnerable to the miscellaneous hazardous physical and mental insults. Hallucinations after MA misuse culminated in a profound damage of the fovea in both eyes (solar retinopathy), this MA abuser presented an impulsive behavior of sun gazing and he continued this deleterious behavior for at least 4 hours. Therefore, he received a large quantity of light energy in a short period of time.