Acquired Bilateral Central Vision Loss in a Young Adult Due to “Poppers Maculopathy”

Abstract

Introduction “Poppers” are recreational drugs that are inhaled to produce euphoria and muscle relaxation [1]. They have been available for several decades, with a side effect profile including hypotension, headache, and tachycardia. Curiously, the first case of popper-related maculopathy was only reported in 2004 [2]since then, this disease has become increasingly diagnosed over the last decade [3]. In fact, recent data has shown that the lifetime usage of poppers is higher than expected with 5-6% of French teenagers 6 and 60% of homosexual males in Australia admitting to having previously used alkyl nitrites [4]. This change in frequency is thought to be for several reasons, including improved detection by newer spectral domain optical coherence tomography (SD-OCT) technologies, recent changes in alkyl nitrite formulation from isobutyl to isopropyl nitrite, and the increased use of recreational drugs among the general population [4-7]. As this entity is becoming increasingly recognised, it is essential for the ophthalmologist to be familiar with this diagnosis as a potential mechanism of acquired vision loss. Herein, we describe a case of “poppers” maculopathy that presented to the emergency ophthalmology clinic at a quaternary hospital center.