Pentosan Polysulfate Maculopathy Following Subcutaneous Injections for Arthritis

Does subcutaneous pentosan polysulfate sodium (PPS) pose a risk of retinal toxic effects, and how does this risk compare with standard oral administration?This case series including 3 patients found that subcutaneous administration of PPS for arthritis treatment was associated with macular toxic effects at very low cumulative dosages (ranging from 45.5 to 96 g) taken for a duration of 7 to 10 years.This study found that presumed pentosan polysulfate maculopathy developed from subcutaneous administration at approximately 10-fold lower doses than reported with oral administration, potentially due to its much higher bioavailability.

Corresponding Author: Adrian T. Fung, MBBS, MMed, Department of Ophthalmology, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia (adrian.fung@sydney.edu.au).

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