Abstract
Purpose :
The associations between pentosan polysulfate sodium (PPS) use and the occurrence of PPS maculopathy remain unclear. This retrospective study of a large cohort of PPS patients analyzed the demographic and clinical variables associated with PPS maculopathy, and estimated the prevalence of maculopathy among PPS patients.
Methods :
This retrospective review used electronic health records (EHR) of patients seen within the Department of Ophthalmology, University of California, San Diego. Patients were identified using structured queries of the EHR data warehouse including “Pentosan polysulfate sodium” listed as outpatient medication and patient encounter at the Shiley Eye Institute.
This was followed by manual chart review which included age, gender, self-identified race, self-identified ethnicity, weight, start date of medication, dosage of the drug, date of discontinuation.
Ophthalmic imaging data was reviewed by a retinal specialist to confirm phenotypic signs of toxicity based on previous reported characteristics. Data analysis was performed using R statistical programming software.
Results :
Initially 128 patients were identified to have used PPS. Of the one-hundred and four patients included, twenty-six (33.3%) presented with pentosan maculopathy. Twenty-four patients were excluded due to lack of imaging or incomplete records. The youngest subject was 39 years of age while the lowest cumulative dose was 4-grams.
The mean age for those with maculopathy was 72.3 (CI = 67.5 – 77.1) years versus 66.6 (63.7 – 69.5) years for those without maculopathy (p = 0.053). The exposure time of subjects with maculopathy (months) (μ = 155.1, P < 0.001, CI = 119.1 – 191.1) was significantly greater than the non-maculopathy group (months) (μ = 69.7), (P < 0.001, CI = 54.1 – 85.3). Additionally, the cumulative dose (g) (μ = 1803.2, P < 0.001, CI = 1380.9 – 2225.5) of maculopathy patients was significantly higher in the maculopathy compared to the non-maculopathy group (g) (μ = 972.6, P < 0.001, CI = 742.2 – 1203.0).
Conclusions :
We identified a relatively high prevalence of PPS maculopathy in PPS patients seen in the Ophthalmology Department. Similar to previous reports, we confirm risk factors for developing PPS maculopathy, with strong associations between the length of exposure, cumulative dose and increased dose to weight of PPS and the occurrence of PPS maculopathy.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.