This 35-year-old man attended eye casualty complaining of a sudden onset of central visual disturbance in both eyes.
OCT revealed a discontinuity of the ellipsoid zone (photoreceptor layer) at the fovea of both eyes with some overlying hyperreflective material. On fundoscopy, these appeared as small yellow lesions at the fovea.
On direct questioning, this patient confirmed that he had used ‘poppers’ the night before. Poppers are volatile alkyl nitrite compounds that are inhaled to enhance sexual experience and for their psychoactive effects. They are most commonly used by gay men. ‘Poppers maculopathy’ has emerged following changes in the chemical composition of these ‘legal highs’.
This condition is self-limiting following cessation of popper use. More information can be found in this case series of patients seen at Sussex Eye Hospital.