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Title	Poppers associated toxic maculopathy
Abstract Nr.	P102

Purpose	We aim at presenting three cases of poppers associated toxic maculopathy. Poppers are volatile nitrite oxide donors, inhaled for recreational purposes. In Belgium, selling it for human consumption is illegal, but it can be easily purchased online. About 10% of the general population are supposed to have tried it. Especially in de gay community it's a popular drug. Recently a toxic poppers associated maculopathy has been reported.
Methods	A case series of 3 male HIV-positive patients. All cases presented at the university clinic in Brussels, with visual impairment and maculopathy after inhalation of poppers.
Results	All 3 patients experienced visual symptoms after using poppers. One complained of a central scotoma, the other two noticed visual impairment. The median age is 36 years (32-46y). All patients are homosexual and HIV-positive. No other ocular or systemic diseases are known. Poppers had been inhaled during 1 month up to 10 years. On fundoscopy the fovea appeared normal except for one patient where it showed typical subtle yellow dots. Optical coherence tomography (HD-OCT) revealed varying degrees of disruption of the inner segment/outer segment (IS/OS) junction. Visual fields and colour vision were normal in all patients.
Conclusion	The inhalation of poppers may lead to maculopathy. Disruption of the presumed IS/OS junction on SD-OCT is a characteristic feature of poppers associated toxic maculopathy. After a reduction of poppers abuse visual symptomes and OCT alterations may diminish. Most likely the disease is often overlooked. Consumers and ophthalmologists should be aware of the possible retinal toxicity of poppers.

Authors 1

Last name	BRAL
Initials	NOG
Department	University Hospital VUB
City	Brussel

Authors 2

Last name	van Lint
Initials	M
Department	University Hospital VUB
City	Brussel

Authors 3

Last name	Hoornaert
Initials	KP
Department	University Hospital Ghent
City	Ghent

Authors 4

Last name	ten Tusscher
Initials	MPM
Department	University Hospital VUB
City	Brussel