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Characteristics of Pentosan Polysulfate Sodium-Associated Maculopathy and Similarities With Other Maculopathies
Collin Ohning1,2, George Skopis2,3, Joshua Levinson1,2
1The Retina Group of Washington, Washington, DC, USA.
Purpose:
This work describes characteristics of pentosan polysulfate sodium (PPS)-associated maculopathy and its similarities with common maculopathies in a retina practice cohort.
Methods:
Thirty-two patients were identified through electronic medical record query who were exposed to PPS. One patient was excluded for lack of retinal imaging. Thirty-one patients (62 eyes) were included. A retrospective review was used to obtain patient characteristics, examination findings, and retinal imaging of the study patients. Classification into "likely," "unlikely," or "possible" to have PPS-associated maculopathy groups was based on the fundus photography and retinal imaging. Main outcome measures were best-corrected visual acuity, age, sex, diagnosis of reason for referral, allocation into designated maculopathy group, and presence of choroidal neovascularization.
Results:
Of 31 patients (62 eyes), the median age was 70 years (range, 24-104 years) and the majority were women (87%). Mean best-corrected visual acuity was 0.3 ± 0.4 logMAR at presentation. The most common reason for referral was age-related macular degeneration (29%). Maculopathy grades were "likely" (29%, 9 total patients), "possible" (26%, 8 total patients), or "unlikely" (45%, 14 total patients). Choroidal neovascularization was noted in 9.7% of all eyes and 11% of eyes in the "likely" group. The "possible" and "likely" groups had older ages of presentation (P < .05) compared with the "unlikely" group.
Conclusions:
A high percentage (55%) of patients with a history of chronic PPS exposure showed features of "likely" or "possible" maculopathy. Similarities with common maculopathies such as age-related macular degeneration and the importance of screening and recognizing at-risk patients are highlighted.
Insights
Pentosan polysulfate sodium (PPS) maculopathy shares features with common retinal conditions. Many patients exposed to PPS develop maculopathy, underscoring the need for screening.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacology
Background:
- Pentosan polysulfate sodium (PPS) is used for interstitial cystitis and osteoarthritis.
- Ocular side effects, including maculopathy, have been anecdotally reported with chronic PPS use.
- Understanding PPS-associated maculopathy is crucial for patient care and monitoring.
Purpose of the Study:
- To characterize pentosan polysulfate sodium (PPS)-associated maculopathy.
- To compare its features with common maculopathies in a clinical cohort.
- To identify risk factors and clinical presentation of PPS maculopathy.
Main Methods:
- Retrospective review of 31 patients (62 eyes) with documented PPS exposure.
- Classification of maculopathy into "likely," "possible," or "unlikely" based on retinal imaging.
- Analysis of best-corrected visual acuity, age, sex, referral diagnosis, and choroidal neovascularization.
Main Results:
- 55% of patients with chronic PPS exposure showed "likely" or "possible" maculopathy.
- The
- likely
- and
- possible
- maculopathy groups were older than the
- unlikely
- group (P < .05).
- Choroidal neovascularization was present in 9.7% of all eyes, and 11% in the "likely" group.
Conclusions:
- A significant proportion of patients on chronic PPS develop maculopathy.
- PPS-associated maculopathy exhibits similarities to age-related macular degeneration and other common maculopathies.
- Screening and recognition of at-risk patients exposed to PPS are essential.
