title: Should central serous chorioretinopathy be added to the list of ocular side effects of phosphodiesterase 5 inhibitors?
abstract: BACKGROUND
  Rare cases of central serous chorioretinopathy (CSC) associated with the intake of sildenafil citrate have been reported, although CSC is not included in the list of phosphodiesterase 5 (PDE5) inhibitor side effects.
  
  
  METHODS
  We present a review of the literature and 2 cases of CSC in 2 men taking PDE5 inhibitors (vardenafil and tadalafil) for erectile dysfunction. In both cases chorioretinopathy appeared after intake of the inhibitor, resolved once the latter was discontinued, reappeared when the inhibitor was restarted and resolved once again after the inhibitor had been discontinued for the second time.
  
  
  CONCLUSIONS
  PDE5 inhibitors used for male erectile dysfunction have been associated with ocular side effects including lid edema, hyposphagma, photophobia, mydriasis, dyschromatopsia, and nonarteritic anterior ischemic optic neuropathy. CSC was previously described in patients taking sildenafil citrate. Very recently, a case of CSC after tadalafil intake was reported. The relevant literature is reviewed and possible pathophysiologic mechanisms are discussed.
  
  
  CONCLUSIONS
  The 2 presented cases of CSC after intake of vardenafil or tadalafil with positive dechallenge, rechallenge and second dechallenge reactions provide important arguments for considering CSC as a rare PDE5 inhibitor class-specific side effect.
authors.affiliation: Department of Ophthalmology, Geneva University Hospital, Geneva, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Aliferis
authors.forename: I K
authors.initials: IK
authors.lastname: Petropoulos
authors.forename: B
authors.initials: B
authors.lastname: Farpour
authors.forename: M A
authors.initials: MA
authors.lastname: Matter
authors.forename: A B
authors.initials: AB
authors.lastname: Safran
mesh_terms: D000368:Aged; D002243:Carbolines / Q000009:adverse effects*; D056833:Central Serous Chorioretinopathy / Q000139:chemically induced* / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000188:drug therapy; D005451:Fluorescein Angiography; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects*; D010879:Piperazines / Q000009:adverse effects*; D013450:Sulfones / Q000009:adverse effects; D000068581:Tadalafil; D041623:Tomography, Optical Coherence; D014227:Triazines / Q000009:adverse effects; D000069058:Vardenafil Dihydrochloride; D014786:Vision Disorders / Q000139:chemically induced / Q000503:physiopathology
chemical_list: D002243:Carbolines; D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil