A person who abuses “poppers” (alkyl nitrites) may develop a maculopathy.


Alkyl groups may include amyl, isopropyl, isobutyl


Risk factors:

(1) heavy and frequent use

(2) isopropyl nitrite


Clinical features:

(1) bilateral decrease in visual acuity, rarely with blindness

(2) central photopsia (flashes of light)

(3) central scotoma

(4) improvement on discontinuation (abstinence)


Findings on the examination:

(1) yellowish spots in the fovea (in the center of the macula)

(2) disruption of the inner segment/outer segment (IS/OS) segment photoreceptor junction on spectral domain optical coherence tomography (SD-OCT)


Differential diagnosis:

(1) photic maculopathy (due to looking at bright lights)

(2) HIV-related ophthalmic infections


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