sildenafil-citrate and Retinal-Artery-Occlusion

Sildenafil is a selective phosphodiesterase type 5 inhibitor used for the treatment of erectile dysfunction and pulmonary hypertension. It is available over the counter in many countries. While there have been a few reports of retinal vascular occlusion following sildenafil consumption, most cases have other comorbidities as risk factors for the disease, and the exact causal role of this drug in these conditions remains unclear.. We present the case of a healthy 32-year-old Iranian man who developed combined central retinal vein occlusion and retinal artery occlusion following sildenafil exposure. The patient underwent a hypercoagulative state workup for possible underlying risk factors. Additionally, we conducted a literature search on PubMed using the keywords: retinal vein occlusion AND Sildenafil OR Viagra, retinal artery occlusion AND Sildenafil OR Viagra, retinal vascular occlusion AND Sildenafil OR Viagra. To obtain more objective results in the reviews, we employed an adverse drug reaction possibility algorithm. The patient was found to be otherwise healthy, and ancillary tests were unremarkable. A literature review identified seven reports of retinal vascular occlusion following sildenafil use. In most of these cases, the role of sildenafil was not clearly established. To the best of our knowledge, our case achieved the highest score based on the algorithm compared with previous reports.. Sildenafil may be associated with severe retinal vascular accidents in otherwise healthy young individuals.

Topics: Adult; Arteries; Humans; Iran; Male; Retinal Artery Occlusion; Retinal Vein; Sildenafil Citrate

Phosphodiesterase type 5 (PDE5) inhibitors are the first line drugs for treatment of erectile dysfunction. Sildenafil (Viagra(R)), tadalafil (Cialis(R)), and vardenafil (Levitra(R)) are from the same class of drugs that inhibit PDE5. Transient visual symptoms such as change in color perception and increased light sensitivity are well-known adverse effects of these drugs and occur in 3-11% of sildenafil users. Vision-threatening (serious) ocular complications, such as nonarteritic ischemic optic neuropathy and cilio-retinal artery occlusion have rarely been reported in PDE5 inhibitor users.. To highlight and analyze the most recently published case literature on serious ocular complications of PDE5 inhibitors.. Search of the peer-reviewed English literature was conducted using Medline. The following databases also were searched: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Global Health, and MD Consult. The causality assessment of the reported adverse drug reactions was analyzed by applying both the World Health Organization (WHO) Probability Scale and the criteria utilized by the National Registry of Drug-Induced Ocular Side Effects.. To scientifically and objectively find out if PDE5 inhibitors are associated with vision-threatening ocular complications.. Eight case reports of serious PDE5 inhibitor-associated ocular complications were identified since January 2006 until February 2011. Case reports included cases of anterior and posterior nonarteritic ischemic optic neuropathy, central retinal vein occlusion, cilio-retinal artery occlusion, acute angle closure glaucoma and optic atrophy after sildenafil use.. There is lack of conclusive evidence to indicate a direct cause-effect relationship between PDE5 inhibitor use and vision-threatening ocular events. Men who use PDE5 inhibitors appear to suffer vision-threatening complications at the same frequency as the general population. However, minor visual adverse effects occur in 3-11% of users and they are transient and reversible.

Topics: Adult; Aged; Child; Erectile Dysfunction; Female; Glaucoma, Angle-Closure; Humans; Male; Middle Aged; Optic Atrophy; Optic Neuropathy, Ischemic; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Retinal Artery Occlusion; Retinal Vein Occlusion; Sildenafil Citrate; Sulfones; Vision Disorders

Topics: Adverse Drug Reaction Reporting Systems; Databases, Factual; Drug-Related Side Effects and Adverse Reactions; Humans; Phosphodiesterase 5 Inhibitors; Product Surveillance, Postmarketing; Pyrimidines; Retinal Artery Occlusion; Retinal Vein Occlusion; Sildenafil Citrate; Tadalafil; United States; United States Food and Drug Administration; Vardenafil Dihydrochloride

Topics: Adult; Angiogenesis Inhibitors; Bevacizumab; Ciliary Arteries; Fluorescein Angiography; Humans; Light Coagulation; Male; Retinal Artery Occlusion; Retinal Vein Occlusion; Sildenafil Citrate; Tomography, Optical Coherence; Vasodilator Agents; Visual Acuity

Topics: Adult; Humans; Kidney Failure, Chronic; Male; Optic Neuropathy, Ischemic; Piperazines; Purines; Retinal Artery Occlusion; Retinal Vein Occlusion; Sildenafil Citrate; Sulfones; Vasodilator Agents

Topics: Humans; Male; Optic Neuropathy, Ischemic; Phosphodiesterase Inhibitors; Piperazines; Purines; Retinal Artery Occlusion; Retinal Vein Occlusion; Sildenafil Citrate; Sulfones; Vasodilator Agents

We report on a case of combined nonarteritic anterior ischemic optic neuropathy (NAAION) and cilioretinal artery occlusion resulting from misuse of sildenafil citrate (Viagra Pfizer Pharmaceuticals, New York, NY).. This is an observational case report.. A 54-year-old white man developed blindness in his left eye after an overdose of Viagra. He was examined and fully evaluated.. Ocular examinations revealed a left relative afferent pupillary defect and a left combined NAAION and obstruction of the ipsilateral cilioretinal artery.. Although ocular side-effects of Viagra are rare, they are potentially blinding. Patients should be warned about the side-effects and against misuse of this agent.

Topics: Blindness; Drug Overdose; Humans; Male; Middle Aged; Optic Neuropathy, Ischemic; Piperazines; Purines; Retinal Artery Occlusion; Sildenafil Citrate; Sulfones

Topics: Humans; Male; Middle Aged; Phosphodiesterase Inhibitors; Piperazines; Purines; Retinal Artery Occlusion; Sildenafil Citrate; Sulfones; Vasodilator Agents; Vision Disorders

Topics: Calcium Channel Blockers; Coitus; Erectile Dysfunction; Humans; Hypertension; Male; Middle Aged; Phosphodiesterase Inhibitors; Piperazines; Purines; Retinal Artery Occlusion; Sildenafil Citrate; Sulfones; Verapamil

Topics: Aged; Erectile Dysfunction; Humans; Male; Phosphodiesterase Inhibitors; Piperazines; Purines; Retinal Artery Occlusion; Sildenafil Citrate; Sulfones; Vision Disorders