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CENTRAL RETINAL VEIN OCCLUSION ASSOCIATED WITH USE OF AMYL NITRITE "POPPERS"
Andrew Lam1, Shilpa Gulati, Bradley S Foster
1Department of Ophthalmology, University of Massachusetts Medical School, Springfield, Massachusetts.
Retinal Cases & Brief Reports
|August 25, 2022
Summary
This study reports the first case of central retinal vein occlusion linked to amyl nitrite (poppers) inhalation. Young patients, especially homosexual men, presenting with retinal vein occlusion and negative hypercoagulable workups should be evaluated for poppers use.
Area of Science:
- Ophthalmology
- Toxicology
- Vascular Medicine
Background:
- Central retinal vein occlusion (CRVO) is a serious vascular condition affecting vision.
- While risk factors like hypertension and hypercoagulability are known, idiopathic CRVO occurs in younger individuals.
- Amyl nitrite, a recreational inhalant, has been anecdotally linked to various adverse health events.
Observation:
- A 38-year-old male presented with acute CRVO in his right eye.
- The patient reported a clear temporal association between amyl nitrite (poppers) inhalation and the onset of CRVO and recurrent visual scotoma.
- Ophthalmic examination revealed cystic macular edema, confirmed by optical coherence tomography.
Findings:
- The patient's CRVO resolved with intravitreal bevacizumab treatment.
- Extensive laboratory workup for hypercoagulable states was negative.
- This case establishes a direct link between amyl nitrite inhalation and CRVO in a young patient.
Implications:
- Clinicians should consider amyl nitrite inhalation as a potential cause of CRVO in young patients, particularly homosexual men.
- A thorough drug use history is crucial in the diagnostic workup of unexplained CRVO.
- Further research is warranted to elucidate the mechanism of amyl nitrite-induced retinal vascular occlusion.
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