Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy Associated with The Use of Sildenafil: A Case Report

Author

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Torfeh Eye Hospital, Tehran, Iran

Abstract

Introduction: Nonarteritic anterior ischemic optic neuropathy (NAION) is a rare condition but one of the most important ocular side effects of sildenafil.

Case Presentation: We presented a 65-year- old man with the history of sudden painless loss of vision in both eyes following taking sildenafil.

Conclusions: Fundus examination revealed blurred margin and elevated disc in both eyes. Visual field defects were bilateral inferior altitudinal defects, and optical coherence tomography (OCT) displayed a prominent nerve fiber layer edema in both eyes. We asserted that use of sildenafil may lead to reduce blood pressure and interfere with microcirculation in the optic nerve head. So,the potential risks of unregulated over-the-counter sexual enhancement supplements such as sildenafil must be educated to the patients using these supplements.

Keywords

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

1.Gorkin L, Hvidsten K, Sobel RE, Siegel R. Sildenafil citrate use and the incidence of nonarteritic anterior ischemic optic neuropathy. Int J Clin Pract. 2006;60(4):500-3. [PubMed: 16620369].
https://doi.org/10.1111/j.1368-5031.2006.00904.x
PMid:16620369 PMCid:PMC1448698
 
2. Hayreh SS. Non-arteritic anterior ischaemic optic neuropathy and phosphodiesterase-5 inhibitors. Br J Ophthalmol. 2008;92(12):1577-80. [PubMed: 19029161].
https://doi.org/10.1136/bjo.2008.149013
PMid:19029161
 
3. Laties AM. Vision disorders and phosphodiesterase type 5 inhibitors: a review of the evidence to date. Drug Saf. 2009;32(1):1-18. [PubMed: 19132801].
https://doi.org/10.2165/00002018-200932010-00001
PMid:19132801
 
4. Pomeranz HD, Smith KH, Hart WM Jr, Egan RA. Sildenafil-associated nonarteritic anterior ischemic optic neuropathy. Ophthalmology. 2002;109(3):584-7. [PubMed: 11874765].
https://doi.org/10.1016/S0161-6420(01)00976-9
PMid:11874765
 
5. Fraunfelder FW. Visual side effects associated with erectile dysfunction agents. Am J Ophthalmol. 2005;140(4):723-4. [PubMed: 16226525].
https://doi.org/10.1016/j.ajo.2005.02.049
PMid:16226525
 
6. Egan RA, Fraunfelder FW. Viagra and anterior ischemic optic neuropathy. Arch Ophthalmol. 2005;123(5):709-10. [PubMed: 15883302].
https://doi.org/10.1001/archopht.123.5.709-b
PMid:15883302
 
7. Beri M, Klugman MR, Kohler JA, Hayreh SS. Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors. Ophthalmology. 1987;94(8):1020-8. [PubMed: 3658362].
https://doi.org/10.1016/S0161-6420(87)33350-0
PMid:3658362
 
8. Hayreh SS, Podhajsky PA, Zimmerman B. Nonarteritic anterior ischemic optic neuropathy: time of onset of visual loss. Am J Ophthalmol. 1997;124(5):641-7. [PubMed: 9372718].
https://doi.org/10.1016/S0002-9394(14)70902-X
PMid:9372718
 
9. Arnold AC, Hepler RS. Natural history of nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 1994;14(2):66-9. [PubMed: 7951929].
https://doi.org/10.1097/00041327-199406000-00002
PMid:7951929
 
10. Mathews MK. Nonarteritic anterior ischemic optic neuropathy. Curr Opin Ophthalmol. 2005;16(6):341-5. doi: 10.1097/01.icu.0000188361.52166.93. [PubMed: 16264343].
https://doi.org/10.1097/01.icu.0000188361.52166.93
PMid:16264343
 
11. Boghen DR, Glaser JS. Ischaemic optic neuropathy. The clinical profile and history. Brain. 1975;98(4):689-708. [PubMed: 1218373].
https://doi.org/10.1093/brain/98.4.689
PMid:1218373
 
12. Escaravage GK Jr, Wright JD Jr, Givre SJ. Tadalafil associated with anterior ischemic optic neuropathy. Arch Ophthalmol. 2005;123(3):399- 400. [PubMed: 15767487].
https://doi.org/10.1001/archopht.123.3.399
PMid:15767487
 
13. Pomeranz HD, Bhavsar AR. Nonarteritic ischemic optic neuropathy developing soon after use of sildenafil (Viagra): a report of seven new cases. J Neuroophthalmol. 2005;25(1):9-13.
https://doi.org/10.1097/00041327-200503000-00003
PMid:15756125
 
14. Fraunfelder FW, Pomeranz HD, Egan RA. Nonarteritic anterior ischemic optic neuropathy and sildenafil. Arch Ophthalmol. 2006;124(5):733-4. [PubMed: 16682597].
https://doi.org/10.1001/archopht.124.5.733
PMid:16682597
 
15. Margo CE, French DD. Ischemic optic neuropathy in male veterans prescribed phosphodiesterase-5 inhibitors. Am J Ophthalmol. 2007;143(3):538-9. [PubMed: 17317413].
https://doi.org/10.1016/j.ajo.2006.10.006
PMid:17317413
 
16. Hayreh SS. Erectile dysfunction drugs and non-arteritic anterior ischemic optic neuropathy: is there a cause and effect relationship?. J Neuroophthalmol. 2005;25(4):295-8. [PubMed: 16340497].
https://doi.org/10.1097/01.wno.0000189059.90057.98
PMid:16340497
 
17. Shibayama J, Oku H, Imamura Y, Kajiura S, Sugasawa J, Ikeda T. Bilateral, nearly simultaneous anterior ischemic optic neuropathy complicated by diabetes and bilateral, small, crowded optic discs. Jpn J Ophthalmol. 2005;49(3):235-8. [PubMed: 15944831].
https://doi.org/10.1007/s10384-004-0179-3
PMid:15944831
 
18. Moschos MM, Margetis I. Bilateral simultaneous anterior ischemic optic neuropathy associated with sildenafil. Case Rep Ophthalmol. 2011;2(2):262-5. [PubMed: 21941503].
https://doi.org/10.1159/000331111
PMid:21941503 PMCid:PMC3177807
 
19. Karli SZ, Liao SD, Carey AR, Lam BL, Wester ST. Optic neuropathy associated with the use of over-the-counter sexual enhancement supplements. Clin Ophthalmol. 2014;8:2171-5. doi: 10.2147/OPTH.S73059. [PubMed: 25378904].
https://doi.org/10.2147/OPTH.S73059
PMid:25378904 PMCid:PMC4218916
 
20. Taner P, Ergin A, Basar MM, Batislam E, Bilgili YK. Sildenafil does not alter retrobulbar hemodynamics in postural variations. J Neuroophthalmol. 2009;29(2):59-64.
https://doi.org/10.1080/01658100590933433
Razavi International Journal of Medicine
Volume 5, Issue 1
January 2017

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