Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA.
Retin Cases Brief Rep. 2022 Nov 1;16(6):724-726. doi: 10.1097/ICB.0000000000001090.
To describe a potential case of pentosan polysulfate maculopathy that seemed to manifest nearly 3 years after drug cessation.
Complete ophthalmic examination, including multimodal fundus imaging, electroretinography, automated perimetry, and molecular testing, was performed.
A 44-year-old woman with a 435 g cumulative exposure to pentosan polysulfate sodium presented 38 months after drug cessation with 6 months of worsening metamorphopsia and prolonged dark adaptation. Fundus examination and multimodal fundus imaging demonstrated characteristic features of pentosan polysulfate maculopathy, and molecular testing was unremarkable. By contrast, color fundus photographs of the same patient acquired at an outside facility 25 months before did not display features consistent with pentosan polysulfate sodium maculopathy.
This case suggests that new-onset clinically detectable pentosan polysulfate maculopathy may develop years after drug cessation. If corroborated, this finding has important ramifications for pentosan polysulfate sodium dosing and surveillance guidelines.
描述 1 例疑似停药近 3 年后出现的聚戊烯糖多硫酸酯黄斑病变病例。
对患者进行全面眼科检查，包括多模态眼底成像、视网膜电图、自动视野检查和分子检测。
患者为 44 岁女性，聚戊烯糖多硫酸酯钠累积暴露量为 435 g，停药后 38 个月时出现 6 个月的进行性视物变形和暗适应延长。眼底检查和多模态眼底成像显示出聚戊烯糖多硫酸酯黄斑病变的特征性表现，分子检测无明显异常。相比之下，在停药前 25 个月在其他医疗机构拍摄的眼底彩照未显示出与聚戊烯糖多硫酸酯钠黄斑病变一致的特征。
该病例提示，停药后数年可能会出现新的、临床上可检测到的聚戊烯糖多硫酸酯黄斑病变。如果这一发现得到证实，将对聚戊烯糖多硫酸酯钠的剂量和监测指南产生重要影响。
