Abstract
Purpose :
Pentosan polysulfate sodium (PPS) is an oral medication used for the management of interstitial cystitis (IC). Recent studies have demonstrated an association between prolonged use and pigmentary maculopathy. However, to our knowledge, no studies have investigated or controlled for the potential association between IC and retinopathy. The aim of this study was to investigate the incidence and risk of retinopathy in patients with and without IC and PPS use.
Methods :
Data for this retrospective cohort study was sourced from TriNetX, a nationwide, multicenter database. Adult, female patients with IC were matched to non-IC controls with a 1:4 ratio on age, sex, race, and ethnicity. Index dates for patients with IC and their matched controls were determined by the first recorded IC diagnosis. Patients could not have a retinopathy diagnosis before their index date. The IC cohort was subdivided according to duration of PPS use: never, less than five years, at least five years. The outcome measure was any one of six retinopathy diagnoses: exudative or nonexudative age-related macular degeneration, drusen, hereditary retinal dystrophy, toxic maculopathy, or unspecified macular degeneration. Univariate and multivariable Cox proportional hazards models were fitted. The multivariable model adjusted for age, race, ethnicity, smoking, and medical comorbidities. Hazard ratios (HRs) were estimated with the non-IC cohort as the reference category.
Results :
The study included 110,300 adult, female patients. There were 22,060 and 88,240 patients with and without IC, respectively. With an average age of 53.92 (SD 16.22) years, 96,110 (87.14%) patients were non-Hispanic white, 8,835 (8.01%) were non-Hispanic black, and 5,355 (4.85%) were Hispanic. Incidence per 100,000 person-years was 173.88 (95% CI 162.96 - 185.53) for patients without IC, 226.63 (95% CI 198.63 - 258.56) for IC without PPS use, 293.02 (95% CI 234.02 - 366.89) for IC with less than five years of PPS use, and 558.91 (409.97- 761.95) for IC with at least five years of PPS use. Adjusted HRs were 1.31 (95% CI 1.13-1.51) for IC without PPS use, 1.70 (95% CI 1.35-2.15) for IC with less than five years of PPS use, and 3.10 (95% CI 2.26-4.27) for IC with at least five years of PPS use.
Conclusions :
Patients with IC had greater incidence and risk of retinopathy. Prolonged PPS use further increased incidence and risk of retinopathy.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.