Pentosan Polysulfate Maculopathy: What Urologists Should Know in 2020

Published:October 09, 2020DOI:



      To conduct a review of current literature to assess whether an association exists between Pentosan Polysulfate Sodium and the development of macular disease, as it is the only oral medication approved by the Food and Drug Administration for the management of interstitial cystitis.

      Materials and Methods

      A systematic review was conducted by the authors separately, with review methods established prior to the conduct of the review. Databases searched included PubMed, Ovid, Medline, EBSCO, and Google Scholar. A search was conducted for the terms “Pentosan Polysulfate Maculopathy,” “Pentosan Polysulfate Retinopathy,” and “Interstitial Cystitis Maculopathy.” All papers reporting on primary data were included. There were no study sponsors.


      A total of 14 papers reporting on primary data were identified. Most papers reported on the development of macular disease in the setting of chronic pentosan polysulfate sodium exposure. No randomized controlled trials have been performed to date and data was insufficient to perform a meta-analysis. Nevertheless, patients with interstitial cystitis were more likely to receive a diagnosis of maculopathy after several years of the medication use.


      Although the nature of the published studies renders them prone to confounders, currently available data suggest an increased risk for developing maculopathy after years of pentosan polysulfate sodium use. In light of this, and the marginal effectiveness of the medication for the average individual, we suggest that education be provided as to the possible association and that regular ophthalmic evaluation be recommended for patients who are continued on chronic Pentosan Polysulfate Sodium.
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      Linked Article

      • Re: Pentosan Polysulfate Maculopathy: What Urologists Should Know in 2020
        UrologyVol. 152
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          I was pleased to see the systematic review of pentosan polysulfate (PPS) maculopathy by Paredes Mogica and De1, in which the authors provide a valuable summary of our current understanding of this condition. Although there is a growing body of literature on the topic in ophthalmic journals,2-6 it is important that urologists assimilate our findings of this drug-associated retinal disease when making treatment decisions for patients with interstitial cystitis (IC).
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