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Type 3 macular neovascularization in a patient with pentosan polysulfate maculopathy
Elodie Bousquet1, Brian A Lee1, Ahmad Santina1
1Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute University of California Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Purpose:
To report the development of type 3 macular neovascularization (MNV) in a patient with pentosan polysulfate sodium (PPS) maculopathy one year after PPS cessation.
Observation:
A 72-year-old woman presented for decreased visual acuity in the left eye. Medical history was significant for interstitial cystitis treated with PPS for 11 years (cumulative dose of 1205 g) and PPS maculopathy. PPS was discontinued 1 year prior to presentation. Blue-light fundus autofluorescence and spectral domain optical coherence tomography confirmed the diagnosis of bilateral PPS maculopathy. OCT-angiography illustrated the development of type 3 MNV with intraretinal fluid in the left eye. Intravitreal injections of aflibercept were initiated with a good visual and anatomical response.
Conclusion And Importance:
This report describes the development of type 3 MNV in a patient with PPS macular toxicity one year after PPS cessation. This complication emphasizes the need for regular retinal surveillance even after discontinuation of the inciting drug.
Insights
Pentosan polysulfate sodium (PPS) maculopathy can develop type 3 macular neovascularization (MNV) even after drug cessation. Regular eye monitoring is crucial for early detection and management of this vision-threatening complication.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacological Toxicity
Background:
- Pentosan polysulfate sodium (PPS) is used for interstitial cystitis.
- Long-term PPS use can lead to PPS maculopathy, a condition affecting the retina.
- This case highlights a potential complication of PPS maculopathy.
Observation:
- A 72-year-old woman with a history of PPS maculopathy presented with decreased vision.
- Diagnostic imaging confirmed bilateral PPS maculopathy.
- Optical coherence tomography angiography revealed new-onset type 3 macular neovascularization (MNV) with intraretinal fluid in the affected eye.
Findings:
- Type 3 MNV developed in a patient with PPS maculopathy one year after discontinuing PPS.
- The new MNV exhibited intraretinal fluid, contributing to visual decline.
- Treatment with intravitreal aflibercept resulted in positive visual and anatomical outcomes.
Implications:
- This case underscores the risk of developing type 3 MNV following PPS maculopathy.
- Ophthalmologists should maintain vigilance for retinal complications even after PPS cessation.
- Continued surveillance is essential for patients with a history of PPS maculopathy to prevent vision loss.
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