Pentosan polysulfate maculopathy: clinical considerations, pathobiology, and causality

Hall BP, Shiromani S, Vanderbeek BL, Datta S, Girardot PE, Rajagopalan A, Nickerson JM, Boatright JH, Jain N · Progress in Retinal and Eye Research

The review that moves the ocular signal from association to causation, working through strength of association, dose-response, absence of confounding by indication, and laboratory evidence of direct toxicity to the retinal pigment epithelium and choroid. It records that the damage can keep progressing after the drug is stopped, that no treatment exists, that screening rates remain low — and it names subcutaneous injection for osteoarthritis as an emerging exposure route to watch.

Population

Systematic appraisal of the clinical, laboratory and epidemiological evidence on PPS maculopathy

Intervention

n/a

Comparator

n/a

Limitations

A narrative synthesis rather than a pooled analysis, and its causality case is built from observational data; the authors declare no conflicting relationships, which is not true of the study on the other side of this question.