June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Characterisation of phenotypes of poppers maculopathy and their link with the visual prognosis and the resolution of OCT changes
Author Affiliations & Notes
  • Laure Van Bol
    Medical retina, Moorfields Eye Hospital, London, United Kingdom
  • Rengin Asl?han KURT
    Medical retina, Moorfields Eye Hospital, London, United Kingdom
  • Pearse Andrew Keane
    Medical retina, Moorfields Eye Hospital, London, United Kingdom
  • Bish Pal
    Medical retina, Moorfields Eye Hospital, London, United Kingdom
  • Sohba Sivaprasad
    Medical retina, Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Laure Van Bol, None; Rengin Asl?han KURT, None; Pearse Keane, Allergan (R), Bayer (R), DeepMind (C), Haag-Streit (R), Heidelberg (R), Novartis (S), Novartis (R), Topcon (R); Bish Pal, Novartis (R); Sohba Sivaprasad, Allergan (F), Allergan (R), Bayer (F), Bayer (R), Novartis (F), Novartis (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3690. doi:
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      Laure Van Bol, Rengin Asl?han KURT, Pearse Andrew Keane, Bish Pal, Sohba Sivaprasad; Characterisation of phenotypes of poppers maculopathy and their link with the visual prognosis and the resolution of OCT changes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3690.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The occurrence of maculopathy as a side effect of poppers inhalation is a well-known fact but the nature of the foveal damage and its visual prognosis remain unclear. We carried out a retrospective and observational study to describe the spectrum of foveal lesions caused by poppers toxicity and to evaluate if the phenotype of maculopathy is related to consumption habits and to visual and anatomical recovery.

Methods : Retrospective analysis of a case series of 39 patients diagnosed with poppers maculopathy in Moorfields Eye Hospital from August 2011 until August 2016.
Symptoms, consumption habits, clinical findings, OCT and autofluorescence features as well as functional tests (if performed) were evaluated.

Results : Of the 39 patients, only 2 were women and the median age was 39 (ranging from 27 to 70). The mean follow up period was 10 months. All patients initially presented with central visual disturbances and visual acuities ranging from 20/20 to 20/60. From the OCT and autofluorescence features, we were able to identify 3 distinct phenotypes: An isolated subfoveal disturbance of the ellipsoid layer (22 patients), a vitelliform-like lesion (13 patients) and a foveal microhole (4 patients). The history of drug exposure, the reversibility of foveal changes and the visual recovery were highly variable and appeared to be related to the phenotype. Indeed, heavy poppers consumption was reported amongst all patients diagnosed with a vitelliform-like maculopathy (weekly consumption during a period ranging from 2 to 15 years) and none showed complete resolution of symptoms or foveal changes over time despite drug cessation. In contrast, amongst the 26 patients presenting with subfoveal disturbance or a microhole appearance, occasional consumption was frequently reported and 9 of them demonstrated a full restitution of normal foveal anatomy after ceasing to consume poppers.

Conclusions : Our results show that poppers maculopathy can manifest in different phenotypes depending on the duration of drug exposure. These changes have long been regarded as reversible, providing that the drug consumption is discontinued. Nevertheless, we found that symptoms and foveal changes associated with chronic drug consumption do not seem to resolve over time.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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