Abstract
A 53-year-old man was attended to the Clinic Ophthalmic Center, Mansoura University, Egypt, with recurrent transient monocular visual loss after receiving sildenafil citrate (Viagra) for erectile dysfunction. Examination for possible risk factors revealed mild hypercholesterolemia. Family history showed that his father had suffered from bilateral nonarteritic anterior ischemic optic neuropathy (NAION). Physicians might look for arteriosclerotic risk factors and family history of NAION among predisposing risk factors before prescribing sildenafil erectile dysfunction drugs.
Highlights
Sildenafil citrate (Viagra; Pfizer Pharmaceuticals, New York, NY, USA) is a selective phosphodiesterase 5 inhibitor and partial phosphodiesterase 6 inhibitor prescribed for erectile dysfunction
Sildenafil intake leads to smooth muscle relaxation in the corpus cavernosum, allowing inflow of blood by enhancing the effect of nitric oxide and cyclic guanosine monophosphatase pathway, during sexual intercourse
It is presumed to result from vascular insufficiency at the optic nerve head leading to ischemia, but the specific mechanism of the vasculopathy remains unproven
Summary
Sildenafil citrate (Viagra; Pfizer Pharmaceuticals, New York, NY, USA) is a selective phosphodiesterase 5 inhibitor and partial phosphodiesterase 6 inhibitor prescribed for erectile dysfunction. Painless transient monocular visual loss is consistent with an ischemia occurring repeatedly in the visual pathway anterior to the chiasm Other conditions such as intermittent angle-closure glaucoma, pigment dispersion glaucoma, optic disc drusen, and papilloedema can cause monocular blindness. Repeated transient monocular visual loss during sexual intercourse has been reported in relation to subacute angle closure [2], and to hypothetical retinal vasospasm [3]. This case revealed transient monocular visual loss in male patient with hypercholesterolemia, and family history of NAION with the use sildenafil citrate (Viagra) for erectle dysfunction
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