Purpose: To describe the development of tractional retinal detachments (TRD) in a patient with diabetic retinopathy (DR) and a history of methamphetamine use. Methods: A single case was evaluated. Results: 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 A1c 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. Conclusions: In patients with underlying DR and presumed Moyamoya disease, TRDs can be exacerbated by methamphetamine use.
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