Pigmentary Maculopathy in Patients with Interstitial Cystitis: Association with Pentosan Polysulfate and Other Therapies

Qin S, Evans JK, Jeong C, Havunjian M, Jain N, Greven MA, Ong SS · Ophthalmology Science

The comparison that removes the disease as an explanation: of 122 patients with retinal imaging, all 8 with pigmentary maculopathy had taken PPS and none of the unexposed did. Moderate or severe cases had a median 121 months of exposure and a median cumulative dose of 929 g, against 35 months and 167 g for mild or absent disease. Concurrent amitriptyline or cyclosporine was more common in affected patients.

Population

336 interstitial cystitis patients with at least two eye examinations at Wake Forest, 2011–2021 — 176 PPS-exposed, 160 never exposed

Intervention

Oral PPS in routine practice

Comparator

Interstitial cystitis patients never exposed to PPS

Limitations

Retrospective and single-centre with only 122 of 336 patients imaged; eight cases is a small base for the co-medication findings, which the authors flag as needing prospective confirmation; PPS-exposed patients were more heavily treated in general, so co-medication associations may track severity.