Abstract
PurposeTo investigate a possible microvascular component of poppers maculopathy (PMP) using optical coherence tomography angiography (OCTA).MethodsTwelve patients suffering from poppers maculopathy were included. Health records, optical coherence tomography (OCT), and OCTA data was gathered and compared to a healthy control group (HC). PMP lesion type was determined by manifestation in OCT. OCTA-based evaluation of retinal vascular plexus and choriocapillaris (CC) was executed. Vessel density (VD) and vessel length density (VLD) in superficial and deep capillary plexus (SCP, DCP), as well as flow deficits (FD), within the foveal avascular zone (FAZ) in CC were assessed.ResultsMedian age of PMP patients was 40 (min 24; max 64) years, all male. Eleven patients presented with ellipsoid zone-type lesions; one patient showed a vitelliform-type lesion. No qualitative microvascular changes between PMP patients and HC were identified. Quantitative values for VD and VLD of SCP and DCP did not differ in between the two groups. The analysis of FDs in CC showed no deviation from PMP patients to HC.ConclusionsNo vascular anomalies in qualitative and quantitative analysis in OCTA were detected in PMP patients. The constitution of the CC within FAZ of PMP patients does not differ from HC when assessed as FD.
Highlights
The term “poppers” describes drugs, which include volatile alkyl nitrites, which are consumed by inhalation of vapor
Poppers maculopathy patients do not show vascular anomalies in qualitative and quantitative analysis in optical coherence tomography angiography (OCTA) when compared to healthy controls
While conventional fluorescein angiography and indocyanine green angiography are limited to two-dimensional analysis and do not allow for selective analysis of CC [12], OCTA allows for three-dimensional analysis of flow signal of the parafoveal vascular arcade in form of SCP, DCP, Fig. 1 Quantification of flow deficits (FD) in the CC: A binarized 6 × 6 mm OCTA slab of the superficial capillary plexus with dotted red ring marking the foveal avascular zone (FAZ); B binarized 6 × 6 OCTA slab of CC with a thickness of 20 μm and an offset of 29 μm below the retinal pigment epithelium (RPE)
Summary
The term “poppers” describes drugs, which include volatile alkyl nitrites, which are consumed by inhalation of vapor. The effects include episodes of arousal, euphoria, and myorelaxation [1, 2]. Poppers maculopathy (PMP) refers to the functional affection of central vision and its structural manifestation as foveal alteration of the outer retinal architecture [2, 3]. In the UK, 10% of the population had exposure to poppers, with higher levels of consumption in the “clubbing” collective and in gay men [1, 5, 6]. Within the population that used poppers in 2015 in the UK, 2.2% reported a drugrelated affection of visual function, with an additional 10% who described a possible effect of poppers use on their eyesight [1]
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