RETINAL STRUCTURAL CHANGES AFTER CESSATION OF PENTOSAN POLYSULFATE SODIUM

Area of Science:

• Ophthalmology
• Retinal Imaging
• Pharmacological Retinopathy

Background:

• Pentosan polysulfate sodium (PPS) is associated with a specific type of retinopathy.
• Understanding the long-term structural changes after PPS cessation is crucial for patient management.

Purpose of the Study:

• To quantify baseline and longitudinal structural changes in patients with pentosan polysulfate sodium retinopathy after drug cessation.
• To compare retinal thickness and hyperreflective retinal pigment epithelium excrescence volume in patients versus age-matched controls.

Main Methods:

• Retrospective cohort study analyzing optical coherence tomography (OCT) scans.
• Manual segmentation of retinal thickness and hyperreflective retinal pigment epithelium excrescence volume.
• Comparison of baseline measurements with controls and longitudinal follow-up data.

Main Results:

• Patients with PPS retinopathy had lower baseline retinal thickness compared to controls (269.1 µm vs. 290.2 µm).
• Significant retinal thinning occurred post-cessation (11.3 µm decrease over ~18.6 months follow-up, annual mean decrease of 6.70 µm).
• Hyperreflective retinal pigment epithelium excrescence volume showed no significant change post-cessation (P = 0.140).

Conclusions:

• Retinal thinning progresses long-term after pentosan polysulfate sodium discontinuation, at a rate exceeding normal aging.
• Despite no significant change in excrescence volume, continued retinal thinning warrants long-term monitoring.
• Suggests the need for vigilant follow-up to manage structural changes in PPS retinopathy.