Table 1. Demographics and clinical features of seven cases of visual changes secondary to poppers inhalation.

Case	Age (years) and sex	Initial BCVA R&L	VA pinhole R&L	Poppers brand	Pattern of use (frequency and timing)	Primary symptoms	Fundoscopy	SD-OCT	Other investigations	Outcome
1	53 Male	6/18	6/9	Liquid gold	Regularly >20 years, daily for 2 years	Fluctuating vision Central scotoma	Yellow foveal lesion	Significant IS/OS disruption and elevation. No change over 5/12	FFA normal VF 10-2 normal FAF normal	Ongoing reduced (weekly) poppers use. No change to VA, signs or symptoms at 5/12
2	32 Male	6/18	6/9	Liquid Gold	>Weekly Regularly >14 years	Fluctuating central vision	Distinct yellow foveal lesion	Significant IS/OS disruption and elevation	FFA normal FAF normal EDT normal VF 10-2 normal	Ceased poppers use. No change to VA, signs or symptoms at 3/12
3	36 Male	6/18	6/12	Unknown	Once 2 Weeks previously	Central scotoma Metamorphopsia	Subtle yellow foveal lesion	2/52: Moderate IS/OS disruption 8/52: Minimal reduction in IS/OS abnormality	—	DNA FFA and clinical F/U
4	37 Female	6/9	—	Purple Haze	Once 1 Day previously	White, positive central scotoma	Yellow foveal lesion	Day 1: Normal 3/12: Moderate IS/OS disruption and elevation 5/12: Slight reduction in IS/OS abnormality	MRI brain normal	Ceased poppers use at month 3. Symptoms improved by month 5. Symptoms recurred at month 17 review (switched to inhaling ‘Liquid Gold' from month 6)
5	44 Male	6/6	—	Jungle Juice	Once 48 h previously	Central scotoma Photophobia	Normal	Subtle IS/OS disruption. Four weeks later returned to normal	Reduced peri-foveal autofluorescence. FFA normal	Symptoms resolved at 6 weeks
6	42 Female	6/6	—	Jungle Juice	Once 48 h previously	White central scotoma Phosphenes	Normal	Minimally reduced IS/OS reflectivity	FAF: focal clumps of reduced RPE autofluorescence	Symptoms gradually improved. Resolved after 6 weeks use
7	33 Male	6/6	—	Unknown	Once Previous night	Dysphotopsia	Normal	Minimally reduced IS/OS reflectivity	—	DNA F/U. Gave incorrect contact details

All findings are bilateral and symmetrical unless stated otherwise.

Abbreviations: BCVA, best-corrected visual acuity; DNA, did not attend; EDT, electrodiagnostic tests; FAF, fundus autofluorescence; FFA, fundus fluorescein angiography; F/U, follow-up; IS/OS, inner segment/outer segment cone junction; MRI, magnetic resonance imaging; SD-OCT, spectral domain optical coherence tomography; VF 10-2, visual fields (Humphrey 10-2 programme).