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Poppers maculopathy missed in a patient with cataract highlights the importance of preoperative optical coherence tomography
  1. Mumta Kanda1,
  2. Mohsan Malik2,
  3. Michael Miller3 and
  4. Rajesh Deshmukh4
  1. 1 A&E, Cataract, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2 Adnexal, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  3. 3 Moorfields Private, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  4. 4 Cataract, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Mumta Kanda; mumta.kanda1{at}nhs.net

Abstract

Poppers maculopathy is a complication of alkyl nitrate (poppers) inhalation. It presents with non-specific symptoms and variable signs, which can make it difficult to diagnose. We present a case of coexisting cataract and poppers maculopathy in a patient. He had vague visual symptoms that were attributed entirely to his cataract and he went on to have cataract surgery. Suboptimal postoperative visual acuity and normal clinical examination triggered further investigation with spectral-domain optical coherence tomography (SD-OCT), after which poppers maculopathy was diagnosed. We highlight the importance of performing OCT in the preoperative assessment of a cataract patient, especially where the cataract is mild and may not fully account for symptoms. The patient showed complete visual recovery on drug cessation despite ongoing maculopathy on OCT scans.

  • Anterior chamber
  • Retina
  • Eye

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: MK, RD, MMiller and MMalik. The following authors gave final approval of the manuscript: RD.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.