Cocaine and choroidal infarction, revisiting the triangular sign of amalric.
OBJECTIVE
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.


CONCLUSIONS
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.
From the *New York University Medical Center, New York, New York; and †Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, California.
Shantan
S
Reddy
Darin R
DR
Goldman
Jean-Pierre
JP
Hubschman
Andrew
A
Kaines
David
D
Sarraf