Discipline of Orthoptics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Semin Ophthalmol. 2023 May;38(4):371-379. doi: 10.1080/08820538.2022.2108717. Epub 2022 Aug 7.
The aim of this systematic review and meta-analysis was to provide an overview of reported cases of poppers maculopathy and a statistical analysis of the clinical presentations, anatomical changes and treatment and follow-up of the rare disease.
A systematic search of CINAHL, Embase and PubMed databases was conducted, including a search of the grey literature. Data were pooled to provide a summary of the clinical characteristics and outcomes of poppers maculopathy. Studies were critically appraised using the Joanna Briggs Institute or the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklists.
Of the 493 articles obtained, 32 were included, consisting of 113 participants with a mean age of 40.2. Most patients were male with bilateral maculopathy and presented with either vision loss or a visual disturbance. Cessation of popper use was the most common form of management prescribed. The mean VA at baseline was 0.22 (logMAR units). For those followed-up, the mean VA significantly improved from 0.24 to 0.11 (Z = -5.800, = <0.001). Bilateral yellow foveal spots were viewed on fundoscopy in 53 patients, and a sub-foveal disturbance of the ellipsoid layer was reported on spectral domain optical coherence tomography in 89 patients. By 6 months, SD-OCT anatomical changes mostly improved or resolved.
Recreational users of poppers who develop maculopathy generally present with vision loss or a visual disturbance secondary to foveal disruption. Patients have a good visual prognosis, with cessation of poppers potentially having a role in improved outcomes. With the high prevalence of use among gay and bisexual men, awareness of related maculopathy and presenting symptoms by clinicians is important to mitigate side effects.
本系统评价和荟萃分析的目的是提供关于 poppers 黄斑病变报告病例的概述，并对这种罕见疾病的临床表现、解剖学变化以及治疗和随访进行统计分析。
对 CINAHL、Embase 和 PubMed 数据库进行了系统检索，并对灰色文献进行了检索。对数据进行汇总，以提供 poppers 黄斑病变的临床特征和结局的综合概述。使用 Joanna Briggs 研究所或权威性、准确性、涵盖范围、客观性、日期、显著性检查表对研究进行批判性评估。
从获得的 493 篇文章中，纳入了 32 篇，包括 113 名平均年龄为 40.2 岁的参与者。大多数患者为男性，双眼黄斑病变，表现为视力丧失或视觉障碍。停止使用 popper 是最常见的治疗方法。基线时的平均 VA 为 0.22（logMAR 单位）。对于那些随访的患者，平均 VA 从 0.24 显著提高到 0.11（Z=-5.800， =<0.001）。53 名患者眼底镜检查可见双侧黄斑中心黄色斑点，89 名患者频域光相干断层扫描报告黄斑中心凹下椭圆层的亚层干扰。6 个月时，SD-OCT 解剖学变化大多改善或恢复。
使用 poppers 导致黄斑病变的娱乐性使用者通常会因黄斑破坏而出现视力丧失或视觉障碍。患者的视力预后良好，停止使用 poppers 可能对改善结果有一定作用。鉴于男同性恋和双性恋男性中 poppers 的高使用率，临床医生对相关黄斑病变和表现症状的认识很重要，可以减轻副作用。
