Optic atrophy after sildenafil use.
BACKGROUND
It has been well-reported that phosphodiesterase-5 (PDE-5) inhibitors, originally investigated for their effect on smooth muscles and now used widely in treatment of erectile dysfunction, can cause mild transient visual disturbances because of their action on inhibiting enzymes involved in retinal transduction. Recently, these medications have been associated with the development of non-arteritic anterior ischemic optic neuropathy (NAAION) with attendant vision loss.


METHODS
An older male patient, previously examined and ocularly healthy, presented asymptomatically with an occult optic neuropathy, not characteristic of NAAION. Neuroimaging and serology failed to reveal any other underlying cause. The patient did, however, report the use of sildenafil during the interval between his previously normal examination and the observation of his optic neuropathy.


CONCLUSIONS
This case details the development of an optic neuropathy with atrophy seemingly associated with the use of sildenafil, although no cause and effect could be conclusively found. This may indicate that medications used in the treatment of erectile dysfunction may be responsible for optic neuropathies other than NAAION.
Sowka
Joseph W
JW
Nova Southeastern University, College of Optometry, Ft. Lauderdale, Florida 33328, USA. jsowka@nova.edu
Neiberg
Maryke N
MN
Vollmer
Lori A
LA
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000368:Aged; D003937:Diagnosis, Differential; D007172:Erectile Dysfunction / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009896:Optic Atrophy / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011687:Purines / Q000009:adverse effects / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000009:adverse effects* / Q000627:therapeutic use; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases