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Repeated use of 'poppers' may disrupt foveal cone outer segments
Arch Ophthalmol. 2011;129(6):703-708.
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Habitual intake of the drug known as "poppers" may be associated with disrupted foveal cone outer segments, leading to prolonged bilateral vision loss, a study found.
Poppers are exogenous volatile nitric oxide donors that are inhaled. In a retrospective, observational case series, six HIV-positive men reported reduced visual acuity after chronic popper use.
All experienced bilateral vision loss, and two showed central photopsia. Initially, visual acuity ranged from 20/50 to 20/25. Functional and anatomical disruption was restricted to the fovea; all had a bilateral yellow foveal spot that was linked to disruption of the outer cone segments.
Three patients used isopropyl nitrite poppers, and three used additional recreational substances such as cannabis and cocaine. Four showed anatomical and/or functional improvement after several months of discontinued popper use.
According to the study authors, patients who used poppers for several years did not show evidence of extrafoveal extension of the lesions or aggravated vision loss, suggesting that toxicity is not cumulative, remains restricted to the fovea and causes limited long-term visual impairment.