Talc emboli and macular ischemia in intravenous drug abuse
T. R. Friberg, E. S. Gragoudas and C. D. Regan
A patient with decreased visual acuity had small, glistening white
particles that were scattered over both posterior poles. Monochromatic
fundus photography revealed ghost vessels and intraluminal particulate
matter in small retinal vessels. Fluorescein angiography demonstrated
nonperfusion of small arterioles and macular capillaries. The patient
admitted to multiple intravenous injections of crushed methylphenidate
(Ritalin) hydrochloride tablets, which contain talc 18 months prior to
examination. To our knowledge, visual loss and irreversible macular
ischemia from talc emboli have not been previously documented.
