Nonarteritic ischaemic optic neuropathy (NAION) after 36 h of intake of sildenafil citrate: first Egyptian case

El‐Domyati, Moetaz; El-Fakahany, Hasan; Morad, K. E.

doi:10.1111/j.1439-0272.2009.00933.x

Cited by 12 publications

(16 citation statements)

References 15 publications

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“…Ischemic optic neuropathy was reported in five cases. It involved one eye in three cases [38,39,41] and both eyes in two [40,43]. Hsien‐wen et al.…”

Section: Resultsmentioning

confidence: 99%

“…Hsien‐wen et al. reported a case of bilateral PION [41], while the others reported cases of NAAION (Table 4) [38,39,41,43].…”

Section: Resultsmentioning

confidence: 99%

“…In the first Egyptian case to be reported [38], a 48‐year‐old male ingested two doses of sildenafil, 25 mg on day 1 and 50 mg after few days. This young man, previously fit and healthy, took sildenafil to improve his sexual performance in the absence of impotence.…”

Section: Resultsmentioning

confidence: 99%

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Are Phosphodiesterase Type 5 Inhibitors Associated with Vision-Threatening Adverse Events? A Critical Analysis and Review of the Literature

Azzouni

Samra

2011

The Journal of Sexual Medicine

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Introduction Phosphodiesterase type 5 (PDE5) inhibitors are the first line drugs for treatment of erectile dysfunction. Sildenafil (ViagraR), tadalafil (CialisR), and vardenafil (LevitraR) 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. Aims To highlight and analyze the most recently published case literature on serious ocular complications of PDE5 inhibitors. Methods 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. Main Outcome Measures To scientifically and objectively find out if PDE5 inhibitors are associated with vision-threatening ocular complications. Results 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. Conclusion 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.

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“…Ischemic optic neuropathy was reported in five cases. It involved one eye in three cases [38,39,41] and both eyes in two [40,43]. Hsien‐wen et al.…”

Section: Resultsmentioning

confidence: 99%

“…Hsien‐wen et al. reported a case of bilateral PION [41], while the others reported cases of NAAION (Table 4) [38,39,41,43].…”

Section: Resultsmentioning

confidence: 99%

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Are Phosphodiesterase Type 5 Inhibitors Associated with Vision-Threatening Adverse Events? A Critical Analysis and Review of the Literature

Azzouni

Samra

2011

The Journal of Sexual Medicine

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“…Since 2001, sporadic cases of NAION due to sildenafil use have been reported [3, 4, 5]. In all these cases, the affection was unilateral and most had a small, crowded optic nerve head (‘disc at risk’).…”

Section: Discussionmentioning

confidence: 99%

“…Increased cGMP results in relaxation and vasodilation of vascular smooth muscle [1, 2] and enhances penile erectile function in men. Some reports suggest that sildenafil use may be associated with nonarteritic anterior ischemic optic neuropathy (NAION) [3, 4], and several patients have developed NAION between 1 and 12 h after taking sildenafil [5]. We report, for the first time, to our knowledge, a case of bilateral simultaneous anterior NAION after taking sildenafil.…”

Section: Introductionmentioning

confidence: 86%

Bilateral Simultaneous Anterior Ischemic Optic Neuropathy Associated with Sildenafil

Moschos

Margetis²

2011

Case Rep Ophthalmol

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We report a case of simultaneous bilateral nonarteritic anterior ischemic optic neuropathy (NAION) due to sildenafil use. A 55-year-old man with an unremarkable medical history presented simultaneous bilateral NAION 8 months after continuous use of sildenafil 4–5 times a month. At presentation, visual acuity (VA) was 0.7 in the right eye (RE) and 0.9 in the left eye (LE). The visual field showed an inferior altitudinal defect in both eyes and a fundus examination revealed prominent optic disc edema in the RE and a crowded optic disc in the LE. The patient was counseled to discontinue sildenafil, and 3 weeks later VA was 1.0 in both eyes and the optic disc edema in the RE was resolved. However, a visual field defect remained in the RE. Three months later, visual fields were unchanged. To the best of our knowledge, this is the first reported case of simultaneous bilateral NAION due to sildenafil use.

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Ophthalmic adverse drug reactions to systemic drugs: a systematic review

Miguel

Henriques

Azevedo

et al. 2014

Pharmacoepidemiology and Drug

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Purpose To perform a comprehensive and systematic review regarding ophthalmic adverse drug reactions (ADRs) to systemic drugs to: (i) systematically summarize existing evidence, (ii) identify areas, ophthalmic ADRs or drugs that lacked systematization or assessment (namely drugs with original studies characterizing specific ophthalmic ADRs but without causality assessment nor without meta-analysis). Methods Systematic review of several electronic databases (last search 1/7/2012): Medline, SCOPUS, ISI web of knowledge, ISI Conference Proceedings, International Pharmaceutical Abstracts and Google scholar. Search query included: eye, ocular, ophthalmic, ophthalmology, adverse and reaction. Inclusion criteria were: (i) Primary purpose was to assess an ophthalmic ADR to a systemic medication; (ii) Patient evaluation performed by an ophthalmologist; (iii) Studies that specified diagnostic criteria for an ocular ADR. Different types of studies were included and analyzed separately. Two independent reviewers assessed eligibility criteria, extracted data and evaluated risk of bias.Results From 562 studies found, 32 were included (1 systematic review to sildenafil, 11 narrative reviews, 1 trial, 1 prospective study, 6 transversal studies, 6 spontaneous reports and 6 case series). Drugs frequently involved included amiodarone, sildenafil, hydroxychloroquine and biphosphonates. Frequent ophthalmic ADRs included: keratopathy, dry eye and retinopathy. Conclusions To increase evidence about ophthalmic ADRs, there is a need for performing specific systematic reviews, applying strictly the World Health Organization's (WHO) definition of ADR and WHO causality assessment of ADRs.Some ophthalmic ADRs may be frequent, but require ophthalmological examination; therefore, ophthalmologists' education and protocols of collaboration between other specialties whenever they prescribe high-risk drugs are suggestions for the future.

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Nonarteritic ischaemic optic neuropathy (NAION) after 36 h of intake of sildenafil citrate: first Egyptian case

Cited by 12 publications

References 15 publications

Are Phosphodiesterase Type 5 Inhibitors Associated with Vision-Threatening Adverse Events? A Critical Analysis and Review of the Literature

Are Phosphodiesterase Type 5 Inhibitors Associated with Vision-Threatening Adverse Events? A Critical Analysis and Review of the Literature

Bilateral Simultaneous Anterior Ischemic Optic Neuropathy Associated with Sildenafil

Ophthalmic adverse drug reactions to systemic drugs: a systematic review

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