Abstract
Objective
Pentosan polysulfate (PPS; ELMIRON, Janssen Pharmaceuticals, Titusville, NJ) is a
U.S. Food and Drug Administration–approved oral medication for interstitial cystitis.
Numerous reports have been published detailing retinal toxicity with the use of PPS.
Studies characterizing this condition are primarily retrospective, and consequently,
alert and screening systems need to be developed to actively screen for this disease.
The goal of this study was to characterize ophthalmic monitoring trends of a PPS-using
patient sample to construct an alert and screening system for monitoring this condition.
Methods
A single-institution retrospective chart review was conducted between January 2005
and November 2020 to characterize PPS use. An electronic medical record (EMR) alert
was constructed to trigger based on new PPS prescriptions and renewals offering ophthalmology
referral.
Results
A total of 1407 PPS users over 15 years was available for characterization, with 1220
(86.7%) being female, the average duration of exposure being 71.2 ± 62.6 months, and
the average medication cumulative exposure being 669.7 ± 569.2 g. A total of 151 patients
(10.7%) had a recorded visit with an ophthalmologist, with 71 patients (5.0%) having
optical coherence tomography imaging. The EMR alert fired for 88 patients over 1 year,
with 34 patients (38.6%) either already being screened by an ophthalmologist or having
been referred for screening.
Conclusions
An EMR support tool can improve referral rates of PPS maculopathy screening with an
ophthalmologist and may serve as an efficient method for longitudinal screening of
this condition with the added benefit of informing pentosan polysulfate prescribers
about this condition. Effective screening and detection may help determine which patients
are at high risk for this condition.
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Article info
Publication history
Published online: March 03, 2023
Accepted:
January 30,
2023
Received in revised form:
December 27,
2022
Received:
August 16,
2022
Publication stage
In Press Corrected ProofFootnotes
This work was presented at the Annual Meeting of the Association for Research and Vision in Ophthalmology (ARVO), Denver, CO, May 1–4, 2022.
Identification
Copyright
© 2023 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
