title: Sequential, non-arteritic anterior ischemic optic neuropathy in patients taking sildenafil: a report of ten cases.
abstract: OBJECTIVE
  To present a summary of 10 cases of non-arteritic anterior ischemic optic neuropathy (NAION) in patients who received phosphodiesterase type 5 (PDE-5) inhibitors.
  
  
  METHODS
  A case series of 10 patients who, after regular intake of Sildenafil, presented with a first episode of NAION in one eye. NAION was diagnosed based on the following criteria: acute, painless, unilateral loss of vision, fundus features consistent with NAION and exclusion of other possible causes.
  
  
  RESULTS
  Despite the initial adverse event (first episode of NAION), all of these patients continued to use the medication and developed a second episode of NAION in the contralateral eye. Only one of the 10 patients presented with bilateral simultaneous NAION.
  
  
  CONCLUSIONS
  This largest case series published to date, reinforces the general consensus that PDE-5 inhibitors are contraindicated in patients with a history of unilateral NAION.
authors.affiliation: Division of Neuro-Ophthalmology, King Khaled Eye Specialist Hospital, Saudi Arabia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Galvez-Ruiz
authors.affiliation: Division of Neuro-Ophthalmology, King Khaled Eye Specialist Hospital, Saudi Arabia.
authors.forename: Nawal
authors.initials: N
authors.lastname: Arishi
keywords: Non-arteritic anterior ischemic optic neuropathy; Phosphodiesterase type 5 inhibitors; Sildenafil