Pentosan Polysulfate Maculopathy Following Subcutaneous Injections for Arthritis: A Case Series

### Patient Information
This report summarizes a multi-institutional retrospective case series involving three patients treated at centers in Miami, Florida; Los Angeles, California; and Sydney, Australia between September 2024 and July 2025. All patients were adults diagnosed with osteoarthritis or inflammatory arthritis and had undergone subcutaneous administration of pentosan polysulfate sodium (PPS) for arthritis management.

– Patient 1: Middle-aged adult with osteoarthritis.
– Patient 2: Adult diagnosed with inflammatory arthritis.
– Patient 3: Adult with osteoarthritis.

All patients presented with visual complaints after prolonged treatment periods ranging between 7 to 10 years. The cumulative subcutaneous PPS doses ranged from 45.5 g to 96 g, notably lower than cumulative doses typically associated with retinal toxicity in oral administration.