title: Foveal damage in habitual poppers users.
abstract: OBJECTIVE
  To describe foveal damage in habitual use of poppers, a popular recreational drug.
  
  
  METHODS
  Retrospective observational case series. Six patients with bilateral vision loss after chronic popper inhalation were seen in 4 university-based ophthalmology departments. Symptoms, medical history, ophthalmic examination, and functional and morphological tests are described.
  
  
  RESULTS
  All patients experienced progressive bilateral vision loss, with central photopsia in 2 cases. Initial visual acuities ranged from 20/50 to 20/25. In all patients, a bilateral yellow foveal spot was present that, by optical coherence tomography, was associated with disruption of the outer segments of foveal cones. Functional and anatomical damage was restricted to the fovea. The poppers involved were identified as isopropyl nitrite in 3 cases. Four patients showed anatomical and/or functional improvement over several months after discontinuing popper inhalation.
  
  
  CONCLUSIONS
  Repeated inhalation of poppers may be associated with prolonged bilateral vision loss due to the disruption of foveal cone outer segments. Retinal damage may progressively improve following drug discontinuation.
authors.affiliation: Clinical Investigation Center 503 of Quinze-Vingts Hospital, Université Pierre et Marie Curie-Paris, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Audo
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sanharawi
authors.forename: Catherine
authors.initials: C
authors.lastname: Vignal-Clermont
authors.forename: Antoine
authors.initials: A
authors.lastname: Villa
authors.forename: Annie
authors.initials: A
authors.lastname: Morin
authors.forename: John
authors.initials: J
authors.lastname: Conrath
authors.forename: Dominique
authors.initials: D
authors.lastname: Fompeydie
authors.forename: José-Alain
authors.initials: JA
authors.lastname: Sahel
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Gocho-Nakashima
authors.forename: Olivier
authors.initials: O
authors.lastname: Goureau
authors.forename: Michel
authors.initials: M
authors.lastname: Paques
mesh_terms: D000328:Adult; D000680:Amyl Nitrite / Q000009:adverse effects*; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications*; D041623:Tomography, Optical Coherence / Q000379:methods*; D015354:Vision, Low / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D013287:Illicit Drugs; D000680:Amyl Nitrite