PPS maculopathy (PPM) was first identified in an article published in 2018 which reported six patients with a pigmentary maculopathy in the setting of chronic exposure to PPS.2 All patients described prolonged dark adaptation, but the most prominent symptom was difficulty reading (four of six patients) despite an average visual acuity of 6/7.5. Three of the six patients underwent automated static perimetry, which revealed paracentral scotomas in both eyes. On average, the patients had taken PPS for 16 years, with a total cumulative drug dose of 2.2 kg. The shortest duration of PPS use in any patient was 12 years. No patients had choroidal neovascularisation, but one had cystoid macular oedema. In a case series of 70 eyes of 35 patients with PPM, six eyes of nine patients had cystoid macular oedema and one eye had choroidal neovascularisation.3 PPM may progress despite cessation of PPS
https://www.mja.com.au/journal/2023/218/8/pentosan-polysulfate-maculopathy-brief-primer-general-practitioners
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