Abstract
Purpose :
Use of pentosan polysulfate sodium (PPS) is associated with maculopathy. There is a need to better identify progression of PPS maculopathy in patients. In addition, the effect of PPS cessation on macula changes is currently unclear.
Methods :
This is a retrospective case-control study. Measurements were made using Heidelberg Spectralis spectral domain optical coherence tomography (SD-OCT) from consecutive patients referred to the UCSD inherited retinal disease clinic with PPS maculopathy and compared with age-matched controls. Retinal and choroidal segmentation was performed using Heidelberg Eye Explorer (version 1.10.4.0). Data was collected using the 9 ETDRS regions of the macula. Statistical analysis used R software. Univariate analyses of retinal and choroidal volume versus age, cumulative dose, and PPS exposure time were done.
Results :
The PPS group had 15 patients, of which 11 were female [mean age 66.9 yrs (60.5, 73.2)]. The control group had 14 patients; 6 were female [mean age 63.1 yrs (60.2, 66.1)].
Total retinal volumes were significantly reduced (p<.05) in PPS patients [7.51 mm3 (7.26, 7.76)] compared to controls [7.96 mm3 (7.70, 8.22)]. This reduction was statistically significant in 6 of 9 ETDRS regions. Choroidal volume was not significantly different between groups.
No significant correlations were found between total retinal volume and age, cumulative dose or exposure time. A significant negative correlation was found between total choroidal volume and age (p-value .009). Choroidal volume was not significantly correlated with cumulative dose or exposure time.
A longitudinal analysis of 8 PPS patients who had ceased PPS (mean follow-up 1.03 yrs (.57, 1.48)) found a significant negative correlation between total volume and time after cessation (slope -0.188, p-value < .001). This was significant in 7 of 9 ETDRS regions. Total choroidal volume was not significantly correlated with time after cessation.
Conclusions :
Our study found retinal volume loss in PPS maculopathy patients, particularly in the para and peri-fovea volume loss compared to age-matched controls. Interestingly, we also noted some progression of retinal volume loss with time, even after cessation of PPS in our cohort.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.