Tractional Retinal Detachment in a Patient With a History of Methamphetamine Use

<b>Purpose:</b> To describe the development of tractional retinal detachments (TRD) in a patient with diabetic retinopathy (DR) and a history of methamphetamine use. <b>Methods:</b> A single case was evaluated. <b>Results:</b> A 38-year-old man with type 2 diabetes mellitus presented to the clinic with worsening blurry vision in both eyes. A fundus examination, fundus photography, and optical coherence tomography were performed. The patient's bilateral TRDs were attributed to poorly controlled DR; thus, he was administered 1 intravitreal aflibercept injection in each eye and scheduled for surgery. His glycosylated hemoglobin A_1c was only 6.3% and was controlled with metformin. In the interim, the patient was admitted for a stroke workup and diagnosed with Moyamoya disease and methamphetamine abuse. <b>Conclusions:</b> In patients with underlying DR and presumed Moyamoya disease, TRDs can be exacerbated by methamphetamine use.