Central serous chorioretinopathy associated with sildenafil.
OBJECTIVE
: To investigate a suspected relationship between central serous chorioretinopathy (CSC) and sildenafil therapy.


METHODS
: For this retrospective, observational case series, the authors reviewed over 1,500 case reports of sildenafil-associated ocular side effects from the postmarketing surveillance databases of the Food and Drug Administration (FDA), the World Health Organization (WHO), and the National Registry of Drug-Induced Ocular Side Effects. They also performed a Medline literature search for "retinopathy, retinal edema, macular edema" (terms associated with CSC) and "sildenafil." They identified 11 cases of CSC in men taking sildenafil.


RESULTS
: In 8 of 11 cases, patients stopped sildenafil therapy when CSC occurred. In 6 of these 8 cases, patients' vision improved after sildenafil cessation. In 3 cases, effects recurred when patients resumed sildenafil therapy, but stopping therapy was not associated with improvement of CSC in every case. Two patients continued to experience CSC after sildenafil cessation.


CONCLUSIONS
: Practitioners who see patients with refractory CSC should consider recommending cessation of sildenafil therapy; however, because of the cyclic nature of CSC, a causal relationship has not yet been established. Additional possible case reports can be sent to the National Registry of Drug-Induced Ocular Side Effects, the FDA, the WHO, or the manufacturer.
Fraunfelder
Frederick W
FW
Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239-4197, USA. eyedrug@ohsu.edu
Fraunfelder
Frederick T
FT
D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000328:Adult; D000368:Aged; D015862:Choroid Diseases / Q000139:chemically induced*; D016208:Databases, Factual; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D011358:Product Surveillance, Postmarketing; D011687:Purines / Q000009:adverse effects; D012164:Retinal Diseases / Q000139:chemically induced*; D012189:Retrospective Studies; D044967:Serum; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000009:adverse effects*
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases