Jacobs Retina Center, University of California San Diego, La Jolla, California, United States of America.
Shiley Eye Institute, University of California San Diego, La Jolla, California, United States of America; and.
Retina. 2023 Sep 1;43(9):1472-1479. doi: 10.1097/IAE.0000000000003844.
To refine the retinal phenotypes of suspected pentosan polysulfate sodium toxicity using ultra-widefield imaging.
Patients with complete dosing profiles who visited the ophthalmology department and with ultra-widefield and optical coherence tomography imaging records were identified using electronic health records at a large academic center. Retinal toxicity was initially identified using previously published imaging criteria, while grading was categorized using both previously reported and new classification systems.
One hundred and four patients were included in this study. Twenty-six (25%) were identified as having toxicity from PPS. The mean duration of exposure and cumulative dose between the retinopathy group (162.7 months, 1,803.2 g) were longer and higher compared with the nonretinopathy group (69.7 months, 972.6 g) (both P < 0.001). There was variability of extramacular phenotype in the retinopathy group, with four eyes having only peripapillary involvement and six eyes having far peripheral extension.
Retinal toxicity in the setting of prolonged exposure and increased cumulative dosing from PPS therapy produces phenotypic variability. Providers should be aware of the extramacular component of toxicity when screening patients. Understanding the different retinal phenotypes may prevent continued exposure and reduce the risk of vision-threatening foveal-involving disease.
利用超广角成像技术完善对疑似聚戊烯硫酸钠毒性的视网膜表型。
通过电子病历，在一个大型学术中心，鉴定出有完整用药记录且有超广角和光相干断层扫描成像记录的眼科就诊患者。最初使用已发表的成像标准来识别视网膜毒性，同时使用已报道和新的分类系统进行分级。
本研究共纳入 104 例患者。26 例（25%）被确定为 PPS 毒性。与非视网膜病变组相比，视网膜病变组的暴露时间（162.7 个月）和累积剂量（1803.2g）更长、更高（均 P < 0.001）。视网膜病变组的周边外表型存在差异，4 只眼仅累及视盘周围，6 只眼有远周边延伸。
PPS 治疗的长时间暴露和累积剂量增加会导致视网膜毒性出现表型变化。在筛查患者时，临床医生应注意毒性的周边外表现。了解不同的视网膜表型可以防止持续暴露，并降低威胁视力的黄斑受累疾病的风险。
