Pentosan polysulfate sodium-induced pigmentary maculopathy with non-leaking cystoid macular edema successfully treated with anti-VEGF therapy.

To report a case of non-leaking cystoid macular edema (CME) associated with pentosan polysulfate sodium (PPS)-induced pigmentary maculopathy.

Multimodal imaging, including optical coherence tomography, fundus photography, autofluorescence and fluorescein angiography, was used to substantiate our diagnosis, further characterize the CME showed by our patient and to monitor the response to treatment.

A 59-year-old woman was referred for decreased visual acuity and bilateral macular edema. She had been treated for interstitial cystitis with PPS for 10 years. Multimodal imaging showed the characteristic features of PPS-induced pigmentary maculopathy. Moreover, fluorescein angiogram showed non-leaking CME in both eyes. She was treated successfully with intravitreal injections of bevacizumab.

To our knowledge, this report is the first to demonstrate that PPS-associated CME can be non-leaking on fluorescein angiography and responds well to intravitreal anti-VEGF injections.

Retinal cases & brief reports. 2020 Jun 05 [Epub ahead of print]

Elianne De Larochellière, Serge Bourgault

Département d'opthalmologie et d'oto-rhino-laryngologie-chirurgie cervico-faciale, Faculté de médecine, Université Laval, Québec, QC, Canada.