Papillophlebitis Following Methamphetamine Abuse in a Middle-Aged Patient: A Case Report

Abstract Purpose: To describe a case of papillophlebitis in a middle-aged male following recent methamphetamine use, highlighting a possible causal relationship. Case Presentation: A 52-year-old male construction worker with no notable systemic or ocular history arrived at the emergency department, reporting sudden and worsening vision loss in his left eye. He mentioned smoking cigarettes and recent methamphetamine use beginning two days prior to symptoms onset. Eye examination showed optic disc swelling, venous engorgement, and peripapillary hemorrhages, indicative of papillophlebitis. No evidence of systemic illness, ocular trauma, or previous similar episodes was found. Macular edema was resolved after single intravitreal bevacizumab injection. Conclusion: This case suggests that the vascular effects of methamphetamine—such as vasospasm, endothelial damage, and hypercoagulability—may induce papillophlebitis even in healthy individuals. Clinicians should inquire about recent stimulant use when evaluating patients with sudden vision loss and monitor closely for potential progression to ischemic central retinal vein occlusion and related complications.