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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Toxicology

Background:

  • Pentosan polysulfate (PPS) is used for interstitial cystitis and osteoarthritis.
  • Ocular toxicity, specifically maculopathy, has been associated with PPS use.
  • Identifying risk factors is crucial for patient safety and informed clinical practice.

Purpose of the Study:

  • To determine the risk factors associated with the development of pentosan polysulfate (PPS) maculopathy.
  • To evaluate the dose-dependency and other contributing factors to PPS-induced ocular toxicity.

Main Methods:

  • A cross-sectional study was conducted involving 187 individuals exposed to PPS at Emory Eye Center.
  • Data were collected via questionnaires and fundus imaging.
  • Multivariate and subgroup analyses identified risk factors for maculopathy.

Main Results:

  • Risk of PPS maculopathy is dose-dependent, with the highest quartile of exposure showing significantly increased risk (OR 39.8).
  • Additional risk factors include cumulative dose per body weight, female sex, older age, and history of inflammatory bowel disease or irritable bowel syndrome.
  • Prevalence of toxicity in PPS users at Emory ranged from 3.8% to 24.5%.

Conclusions:

  • Cumulative PPS exposure is the primary driver of maculopathy risk.
  • Age, gender, and body weight may also play a role in PPS toxicity.
  • Findings support the need for revised dosing guidelines and screening protocols for PPS users globally.