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Maculopathy Secondary to Pentosan Polysulfate Use: A Single-Center Experience

Authors Kalbag NS, Maganti N, Lyon AT, Mirza RG

Received 5 October 2020

Accepted for publication 13 January 2021

Published 11 February 2021 Volume 2021:15 Pages 513—519


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Neil S Kalbag, Nenita Maganti, Alice T Lyon, Rukhsana G Mirza

Department of Ophthalmology, Northwestern University, Chicago, IL, USA

Correspondence: Rukhsana G Mirza
Department of Ophthalmology, Northwestern University, Chicago, IL, USA

Aim: To investigate the prevalence of retinal pathology in patients with a history of exposure to pentosan polysulfate sodium (PPS).
Methods: Patients exposed to PPS and seen in the ophthalmology clinic at Northwestern University during 1/1/2002 to 1/1/2019 were identified from electronic health records (EHR) by an electronic data warehouse (EDW) search. Visual acuity (VA), reasons for clinic visit, ocular conditions, and duration of exposure to PPS were noted. Chart review was performed for fundus exam findings and ophthalmologic imaging, specifically fundus photography, fundus autofluorescence, and ocular coherence tomography (OCT) images. When OCT or fundus photography was available, studies were evaluated by two independent graders.
Results: A total of 131 patients who were exposed to PPS and seen at the Northwestern Ophthalmology clinic were identified in the EHR. Forty patients of 131 had imaging. Patients with imaging or fundus examination suspicious for PPS maculopathy were placed into the suspect group. Of the 40 patients that had imaging, 5 (12.5%) had features suspicious for PPS maculopathy. Of the remaining 91, 5 (5.4%) had macular pigmentary changes described on fundus exam. Among the 10 patients in the suspect group, the average duration of PPS use was 4.2 years (range 0.3– 11.6 years, interquartile range 5.5 years) and the average cumulative dose was 380g (range 29– 1092g, interquartile range 132g).
Conclusion: A novel drug-induced maculopathy has been associated with PPS use with a distinct clinical constellation that can be accurately identified with multimodal imaging.

Keywords: interstitial cystitis, IC, maculopathy, pentosan polysulfate sodium, PPS

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