Clinical and functional evaluation of popper retinopathy in multidrug users: A retrospective case series.

Session Details

Session Title: Free Paper Session 19: Vascular Diseases & Diabetic Retinopathy V

Session Date/Time: Saturday 09/09/2017 | 16:30-18:00

Paper Time: 16:36

Venue: Room 120

First Author: : R.Mastropasqua UK

Co Author(s): :    E. Cinosi   S. Bhandari   G. Martinotti   L. da Cruz                    

Abstract Details

Purpose:

This retrospective, non-comparative, consecutive case series aims to evaluate the clinical and functional features of patients affected by popper retinopathy and assess whether the use of other recreational drugs can influence the disease progression.

Setting:

Moorfields Eye Hospital, London UK

Methods:

All patients with the specific diagnosis of Popper Retinopathy (PR) were included in this study. Cases of uncertain diagnosis (eg. solar maculopathy) were excluded. The data collection included a follow-up starting at the time of the diagnosis up to the last visit attended by the patient. All the participants were investigated regarding age, gender, comorbidities and pattern of substance abuse including nitrates chemical characterization and other recreational drugs. A medical history with respect to visual symptoms and a clinical evaluation of the fundus oculi were obtained from all the record review. The visual acuity (VA), using the patients’ habitual best correction (unaided, spectacles or contact lenses), was recorded at the time of the diagnosis and at the last follow-up.The macular anatomy was studied by mean of OCT scans.

Results:

A total of 18 cases diagnosed with PR were identified. All patients were male, and their age range was 27-60 years. Five patients were HIV-positive, 4 had comorbid depression, 2 had comorbid learning difficulties and 1 had obsessive-compulsive disorder. Eleven out of 18 (61%) cases were regularly misusing other substances including Amphetamine, Cocaine, Ketamine and Kumagra assumed singularly or in combination. The follow-up period was between 6 and 56 months. At the time of the diagnosis, all cases had a bilateral manifestation of the disease involving a reduced central vision associated with the finding of a symmetrical yellow macular deposit. The OCT showed the typical disruption of photoreceptors layer at the level of the fovea. Of the 18 patients, 9 (50%) a total recover in terms of visual acuity and a total or nearly total resolution of the morphological abnormality. Out of 9 patients who did not show any improvement during the follow-up 8 (89%) were using other illicit substances Eleven cases (61%) were able to cease the popper use permanently. Of this subgroup, 7 (64%) cases had a total visual recover while in 6 (54%) the OCT showed total or nearly total resolution of the morphological abnormality.

Conclusions:

Popper Retinopathy is known to be reversible by ceasing the use of nitrates. Multidrug users seem to have a more severe and irreversible manifestation of the disease. Both end-users and health-care professionals should be aware of the potentially serious damage that poppers can have on vision.

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