SOE 2023: Development of maculopathy after excessive caffeine and alcohol intake

Paracentral acute middle maculopathy can develop after excessive intake of caffeine and alcohol according to Obadah Moushmoush, MD. Image credit: ©Praneat – stock.adobe.com

Reviewed by Obadah Moushmoush, MD

Paracentral acute middle maculopathy can develop after excessive intake of caffeine and alcohol according to Obadah Moushmoush, MD, a resident at the Georgetown University, Washington DC. He reported the effects on the retina at the European Society of Ophthalmology Conference, Prague.

He described the case of a 49-year-old Caucasian man with no previous relevant medical history who presented to the retina clinic with the complaint of acute-onset blurred and distorted vision in the right eye.

The symptoms, which began 2 weeks before the patient presented, were described as looking through a dark storm cloud. The blurriness was localized to a specific spot in the right eye 20 degrees to the right of the central vision.

The examination revealed bilateral acuity levels of 20/15 and intraocular pressures of 17 mmHg; there was no afferent pupillary defect and a full range of extraocular muscle movement. The maculas and with no obvious retinopathy and the retinal peripheries were flat and attached. The optic nerve head and cup-to-disc ratio were unremarkable. Fundus photographs, fundus autofluorescence, fluorescein angiography images were normal.

Humphrey visual field evaluation showed a paracentral defect inferiorly. Optical coherence tomography images of the right eye showed thinning superiorly and distortion of the middle macula.

A diagnosis of paracentral acute middle maculopathy was established.

Upon further questioning, Dr. Moushmoush reported, the patient admitted to drinking about seven Red Bulls and vodka the night before the onset of symptoms.