High-Resolution Optical Coherence Tomography Findings in Solar Maculopathy and the Differential Diagnosis of Outer Retinal Holes

Is the mechanism of ‘poppers maculopathy’ photic injury?

“…Furthermore, it is now increasingly recognised that the signs of alleged solar maculopathy on SD-OCT imaging are varied. As discussed in our paper, it is not possible to prove causality of poppers maculopathy and we agree that differential diagnosis of outer lamellar defects can be challenging 4 and that a detailed history should be taken.…”

“…In both 'poppers maculopathy' and photic maculopathy, there is focal disruption of the IS-OS junction centred at the fovea. [1][2][3][4] Moreover, the size, shape, echogenicity, and temporal evolution of the SD-OCT lesions appear indistinguishable in the two conditions. Patients also present with the same symptoms (scotoma, reduced vision, and phosphenes) and have the same slit-lamp findings (a pale yellow foveal lesion).…”

“…The endemic use of poppers 4 and the mere handful of reports of maculopathy suggests that compounding factors or susceptibilities may be involved. It is not inconceivable that 'poppers maculopathy' represents a sub-group of patients who have unrecognised photic injury.…”

“…Patients also present with the same symptoms (scotoma, reduced vision, and phosphenes) and have the same slit-lamp findings (a pale yellow foveal lesion). [1][2][3][4] Indeed, it appears that in people using poppers, the two conditions can only be reliably distinguished by eliciting a history of excess light exposure and not by clinical features.…”

Adverse ophthalmic reaction in poppers users: case series of ‘poppers maculopathy’

“…The primary differential diagnosis includes inter alia photic maculopathy and adult onset foveomacular vitelliform dystrophy. 22,23 We have highlighted this message to the Royal College of Ophthalmologists, to the Lesbian and Gay Foundation, and to the UK Home Office Advisory Council for the Misuse of Drugs. Surveillance for this matter in the United Kingdom may now be of merit.…”