The changing chemical composition of ‘poppers’ carries a risk of retinal damage, ophthalmologists warn today.
Dr Rebecca Rewbury of Cheltenham General Hospital, UK, and colleagues write in today’s British Journal of Ophthalmology that: "Poppers are volatile alkyl nitrite compounds that are inhaled to enhance sexual experience and for their psychoactive effects."
One rarely-considered side-effect is foveal maculopathy, damage to the macula near the centre of the retina, which central vision. "This has emerged following changes in their chemical composition," write the experts.
It is unknown whether certain people are more susceptible to retinal damage, or if there are links between pattern of inhalation and brands used. So the team examined a case series of 12 male patients aged 31 to 59 years, presenting to Sussex Eye Hospital, Brighton, with disrupted central vision occurring soon after inhalation.
All showed disruption of the inner segment/outer segment junction, the team reports. "In general, symptomatic resolution, alongside partial, if not full, recovery of foveal architecture was observed following abstention," they add.
"On the basis of the products tested here, it seems that isopropyl nitrite is toxic to the fovea and can cause significant visual disturbance," the authors write.
"The production of poppers is unregulated and their popularity is concerning, particularly given their exemption from the Psychoactive Substances Act 2016, which might suggest that they are harmless chemicals."
Poppers were made exempt from the Psychoactive Substances Act 2016 as they don’t directly affect the central nervous system. The authors call for further analysis of popper products, especially as different versions may have differing strengths and contaminants.
Rewbury, R. et al. Poppers: legal highs with questionable contents? A case series of poppers maculopathy. British Journal of Ophthalmology 10 April 2017; doi 10.1136/bjophthalmol-2016-310023 [abstract]
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