Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
Retin Cases Brief Rep. 2024 Sep 1;18(5):549-552. doi: 10.1097/ICB.0000000000001440.
To report a case of angiographically silent cystoid macular edema (CME) secondary to pentosan polysulfate sodium (PPS) maculopathy responsive to intravitreal steroids.
Observational case report.
A 52-year-old female patient with a history of 4 years of PPS use for interstitial cystitis presented with PPS maculopathy that developed CME 2.5 years after drug cessation and had associated progression of pigmentary and atrophic changes. Her CME was nonresponsive to topical ketorolac and dorzolamide, but was responsive to intravitreal triamcinolone acetonide and subsequently intravitreal dexamethasone implant (Ozurdex) with reduction in central subfield thickness and improvement in visual acuity.
Cystoid macular edema secondary to PPS maculopathy may be angiographically silent yet responsive to intravitreal steroids alone without the use of vascular endothelial growth factor agents. There is potential for both anatomic and functional improvements in such cases demonstrating the value of such treatment. Cystoid macular edema may be a delayed finding that can develop despite drug cessation. Steroid monotherapy should be further evaluated as possible first-line management for PPS maculopathy-associated CME.
报告一例继发于聚戊烯糖硫酸钠（PPS）黄斑病变的造影不显的囊样黄斑水肿（CME），对其采用玻璃体腔类固醇治疗有效。
观察性病例报告。
一名 52 岁女性患者，有 4 年膀胱炎病史，曾使用 PPS 治疗，停药 2.5 年后出现 PPS 黄斑病变，并发 CME 以及色素和萎缩性改变进展。她的 CME 对局部应用酮咯酸和多佐胺无反应，但对玻璃体腔曲安奈德治疗有反应，随后对玻璃体内地塞米松植入物（Ozurdex）治疗有反应，中心凹下视网膜厚度减少，视力提高。
继发于 PPS 黄斑病变的 CME 可能在造影时不显，但单独使用玻璃体腔类固醇治疗有效，无需使用血管内皮生长因子药物。这种情况下，可能会出现解剖和功能的改善，证明这种治疗的价值。CME 可能是一种延迟发现的疾病，即使停药后也可能发生。对于 PPS 黄斑病变相关 CME，类固醇单药治疗应进一步评估为可能的一线治疗方法。
