Central Serous Chorioretinopathy in a Patient Taking Sildenafil Citrate

Allibhai, Zishan A; Gale, Jeffrey; Sheidow, Thomas S

doi:10.3928/1542-8877-20040301-16

Cited by 39 publications

(24 citation statements)

References 6 publications

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“…Decreased choroidal blood flow could plausibly be involved. Cases of CSCR have been reported in patients using PDE‐5 inhibitors (Allibhai et al. 2004; Quiram et al.…”

Section: Discussionmentioning

confidence: 99%

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)

Kim

Silverman

Chan

et al. 2012

Acta Ophthalmologica

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Objective To demonstrate anatomic and physiologic changes in the human choroid following systemic sildenafil citrate (ViagraR) using enhanced depth imaging spectral domain-optical coherence tomography (EDI-OCT) and swept-scan high frequency digital ultrasound. Methods Seven healthy male subjects (mean age 32.7 years) were evaluated at baseline and two hours after ingesting 50 mg of sildenafil. Swept-scan high frequency digital ultrasound and EDI-OCT were utilized to measure choroidal perfusion and thickness, respectively. Results were read by masked observers. The Wilcoxon signed-rank test and t-test were used to analyze differences in choroidal flow and thickness at baseline and two hours after ingestion of sildenafil. Results Two hours following sildenafil, increased choroidal perfusion was observed in 11 of 12 eyes measured by swept-scan high frequency digital ultrasound. The mean increase was 3.46 (±2.00) times baseline with a range of 0.47 to 7.80 times baseline (p=0.004). Increased choroidal thickness was observed in 12 of 12 eyes measured with EDI-OCT. The average choroidal thickness increased by 11.6% temporal to the fovea, 9.3% nasal to the fovea, and 10.7% underneath the fovea (p<0.001 for all values). Conclusions Choroidal perfusion and thickness both increase in response to systemic sildenafil. These changes could secondarily affect retinal function, explain previously reported clinical symptoms, and potentially be a useful adjunct for treatment of ocular diseases that would benefit from increased choroidal blood flow.

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“…Decreased choroidal blood flow could plausibly be involved. Cases of CSCR have been reported in patients using PDE‐5 inhibitors (Allibhai et al. 2004; Quiram et al.…”

Section: Discussionmentioning

confidence: 99%

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)

Kim

Silverman

Chan

et al. 2012

Acta Ophthalmologica

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“…There have been three reported cases of serous macular detachment associated with sildenafil use 76,77 . The first report was of a 37‐year‐old man who developed central serous chorioretinopathy 6 h following the ingestion of sildenafil 50 mg 77 . Fluorescein angiography confirmed the diagnosis of central serous chorioretinopathy showing leakage along the superotemporal arcade 77 .…”

Section: Serous Macular Detachmentmentioning

confidence: 98%

“…Serous detachment of the neurosensory retina can occur with any process that disrupts the outer blood‐ocular barrier 76 . In central serous chorioretinopathy the exact pathophysiology is unknown but abnormalities in choroidal perfusion are believed to play a role 77 . Localized vascular congestion and impairment of circulation results in ischaemia allowing exudation of choroidal fluid through a focally hyperpermeable choroid resulting in detachment of the neurosensory retina 77 .…”

Section: Serous Macular Detachmentmentioning

confidence: 99%

“…In central serous chorioretinopathy the exact pathophysiology is unknown but abnormalities in choroidal perfusion are believed to play a role 77 . Localized vascular congestion and impairment of circulation results in ischaemia allowing exudation of choroidal fluid through a focally hyperpermeable choroid resulting in detachment of the neurosensory retina 77 . Because of the known effects of PDE5 inhibitors on the choroidal circulation and implication of impaired choroidal circulation in the pathogenesis of central serous chorioretinopathy, it is feasible that PDE5 inhibitors may result in serous macular detachment 77 …”

Section: Serous Macular Detachmentmentioning

confidence: 99%

Section: Serous Macular Detachmentmentioning

confidence: 99%

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Phosphodiesterase inhibitors and the eye

Kerr

Danesh‐Meyer

2009

Clinical Exper Ophthalmology

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Phosphodiesterase type 5 (PDE5) inhibitors are effective oral treatments for erectile dysfunction and have become one of the most widely prescribed medications worldwide. The mechanism of action is to reduce the degradation of cyclic GMP (cGMP) potentiating the effect of nitric oxide in the corpus cavernosum and allowing erectile function to occur by consequent relaxation of penile smooth muscle. Because of the presence of PDE5 in choroidal and retinal vessels these medications increase choroidal blood flow and cause vasodilation of the retinal vasculature. The most common symptoms are a blue tinge to vision and an increased sensitivity to light. There have been reports of non-arteritic anterior ischaemic optic neuropathy and serous macular detachment in users of PDE5 inhibitors, although a causal relationship has not been conclusively shown. Despite the role of cGMP in the production and drainage of aqueous humour these medications do not appear to alter intraocular pressure and are safe in patients with glaucoma. All PDE5 inhibitors weakly inhibit PDE6 located in rod and cone photoreceptors resulting in mild and transient visual symptoms that correlate with plasma concentrations. Psychophysical tests reveal no effect on visual acuity, visual fields or contrast sensitivity; however, some studies show a mild and reversible impairment of blue-green colour discrimination. PDE5 inhibitors transiently alter retinal function on electroretinogram testing but do not appear to be retinotoxic. Despite the role of cyclic nucleotides in tear production there is no detrimental effect on tear film quality. Based on the available evidence PDE5 inhibitors have a good ocular safety profile.

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Tadalafil-Induced Subretinal and Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and Ciliary Body) Melanoma

Abramson¹

2006

Arch Ophthalmol

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Central Serous Chorioretinopathy in a Patient Taking Sildenafil Citrate

Cited by 39 publications

References 6 publications

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)

Phosphodiesterase inhibitors and the eye

Tadalafil-Induced Subretinal and Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and Ciliary Body) Melanoma

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Central Serous Chorioretinopathy in a Patient Taking Sildenafil Citrate

Cited by 39 publications

References 6 publications

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra®)

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra®)

Phosphodiesterase inhibitors and the eye

Tadalafil-Induced Subretinal and Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and Ciliary Body) Melanoma

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Product

Resources

About

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)

Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra^®)