Retina-Vitreous
2014 , Vol 22 , Num 2
Nonarteritic Anterior Ischemic Optic Neuropathy in a Young Male Patient Taking Sildenafil Citrate
1M.D. Şişli Etfal Training and Research Hospital, Eye Clinic, Ankara/TURKEY2M.D. Associate Professor, Şişli Etfal Training and Research Hospital, Eye Clinic, Ankara/TURKEY Sildenafil (Viagra), Phosphodiesterase 5 (PDE-5) selective inhibitor and partial phosphodiesterase 6 (PDE-6) inhibitor is frequently prescribed for treatment of erectile dysfunction (ED).1 Instances of nonarteritic ischemic optic neuropathy (NAION) and permanent vision loss following ingestion of PDE-5 selective inhibitor have been reported.2-4
Sildenafil has been approved for the treatment of ED since 1998, and more than 150 million prescriptions have been written for more than 27 million men worldwide, many of whom are older, vasculopathic, and at risk for NAION.5 A few cases of NAION following PDE-5 selective inhibitor intake have been reported with no vasculopathy risk.5
Our case was a 35 year old male patient who has been taking this medicine for three years without prescription. The only identifiable risk factor was small optic cup/optic disc ratio. The patient was evaluated clinically by angiography and optic coherence tomography.
Keywords : Sildenafil, nonarteritic anterior ischemic optic neuropathy, small optic cup/optic disc