Talc retinopathy presenting as multiple retinal arteriolar occlusions.
OBJECTIVE
To describe a patient with bilateral retinal arteriolar occlusions secondary to talc in the associated vessels resulting from intravenous drug use and a patent foramen ovale.


METHODS
A 24-year-old woman presented with bilateral retinal arteriolar occlusions with visible foreign material in the associated vessels. A transesophageal echocardiogram showed a patent foramen ovale. A subsequent chest computed tomography angiogram showed a diffuse fine nodular pattern with focal nodules bilaterally and lung biopsy showed a foreign body giant cell reaction to polarizable material consistent with talc. This patient's patent foramen ovale allowed larger talc particles to enter her systemic circulation obstructing several retinal arterioles creating an atypical appearance of talc retinopathy.


CONCLUSIONS
To our knowledge, this is only the second case report of talc causing arteriolar occlusions and displays the characteristic lung computed tomography angiogram and histopathologic findings associated with systemic talcosis.
From the Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee.
Ryan
R
Tarantola
David
D
Reichstein
David
D
Morrison
Anita
A
Agarwal