The 12 patients who presented to the Sussex Eye Hospital were all men and ranged in age from 31 to 59 years. Four were HIV positive, with their infections controlled through antiretroviral medication. Two had used poppers for the first time, three were occasional users and four were regular users.
The ocular symptoms the patients most frequently reported were blurriness or scotoma of the central vision. The onset occurred within hours or days of the popper use.
In all cases, the anterior segment and intraocular pressures appeared normal. But yellow foveal deposits appeared on fundoscopy. And these spots corresponded to a subtle area of hyperfluorescence in the four patients who had fundus autofluorescence.
In all the patients, spectral domain optical coherence tomography (SD-OCT) showed characteristic disruption of the inner segment/outer segment (IS/OS) junction in the subfoveal region, with varying amounts of retinal elevation. These findings were unilateral in two patients.
The researchers analysed contents of eight products: Platinum, Hard-on Rush, Berlin XXX hardcore, Liquid Gold, Jungle Juice (yellow label) and Jungle Juice Plus (silver label).
Proton nuclear magnetic resonance (1H NMR) spectra results for six of the products were almost identical and showed an approximate 50:50 mixture of isopropyl nitrite and isopropyl alcohol.
Nitrites easily convert to their corresponding alcohols in the presence of water. A common household product, isopropyl alcohol can cause headache, dizziness and drowsiness.