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Elmiron® (pentosan polysulfate sodium (PPS)- prescribed for Bladder pain) associate with Eye damage!

There has been a recent discovery linking the drug Elmiron® to Eye damage.  Elmiron® is prescribed for “interstitial cystis” (IC), which is long term bladder pain that predominately affects females.  This bladder pain often manifests itself in urinary urgency and dyspareunia.

A recent study[1] by the Emory University Eye Center, studied 219 patients who suffered from IC.  Of the 219 IC patients, 80 of them were taking PPS or Elmiron®.  Fourteen (14) of the patients in the study suffered from “maculopathy” and all such patients were exposed to Elmiron®.  The Emory study showed a very strong association of PPS – Elmiron® to pigmentary maculopathy.  In fact, PPS exposure emerged as the sole statistically significant predictor of the maculopathy in the study. Other studies have confirmed the association as well.

The average age of persons in the Emory Eye study was 60, and the average (median) duration of PPS (Elmiron®) intake was 14.5 years.  Most people take Elmiron for a very long time and every day as bladder pain and dyspareunia are chronic conditions.  Taking Elmiron for bladder pain has been described as a “chemical band-aid” for the bladder and the mechanism of the drug is that it builds up on the bladder walls over time.  It is for this reason that increased consumption of Elmiron® over time is correlated to an increased risk of developing maculopathy.

The median duration of Elmiron® usage among affected patients in the study (with maculopathy) was 18.3 years.  Over this period time, the drug Elmiron builds up in the body and it is thought that this build-up may lead to increased propensity for macular eye damage over time as well.

The eye damage (pigmentary maculopathy) caused by Elmiron® often manifests itself as prolonged dark adaptation and blurred vision while reading.  On examination, patients in the Emory study often had paracentral spots of hyperpigmentation accompanied by pale yellow or orange deposits in their retina.

It is likely that your Optometrist or Ophthalmologist has not even heard of pigmentary maculopathy caused by exposure to Elmiron® since the studies are new.  Many eye doctors, unaware of Elmiron induced pigmentary maculopathy mistakenly diagnose their patients with age-related macular degeneration (AMD) or macular pattern dystrophy.

 If your eye doctor is made award of the association between Elmiron® and pigmentary maculopathy, she or he can order comprehensive fundus imaging (color fundus photography, FAS imaging and OCT), followed by annual examinations with fundus imaging.  A baseline fundus imaging is generally recommended starting at five years after initiation of Elmiron® therapy. This type of retinal imaging is generally not expensive, widely available, and is extremely valuable for highlighting the characteristics of macular degeneration caused by Elmiron®.

If you or a loved one has taken Elmiron® for bladder pain and been diagnosed with age-related macular degeneration (AMD) or macular pattern dystrophy or suffer from blurred vision while reading or prolonged dark adaptation, we encourage you to call us immediately to learn more at 612-767-7505.

[1] Clinical Pearls for a New Condition, Review of Ophthalmology, Published 10 July 2019.  Authors Adam M. Hanif, MD and Nieraj Jain, MD, Atlanta.

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