ABSTRACT.Purpose: To investigate the effects of sildenafil, a popular new drug in the treatment of erectile dysfunction, on ocular blood flow. Methods: This study was designed as a prospective, double-blind, placebocontrolled study. Twenty participants with erectile dysfunction were given a single oral dose of 100 mg sildenafil, while 10 participants with erectile dysfunction were given placebo. All the participants underwent routine systemic and ophthalmological examinations. Intraocular pressure, systolic and diastolic blood pressure and ocular blood flow (ophthalmic, central retinal, short posterior ciliary arteries) were measured in both eyes before and 1 hour after the dose of sildenafil or placebo. Ocular blood flow measurements were performed using colour Doppler ultrasonography. Results: None of the parameters were significantly different between the groups before study drug intake. Although central retinal artery velocities were not changed, ophthalmic artery and short posterior ciliary artery peak systolic velocity, end-diastolic velocity, and mean velocity values were significantly increased 1 hour after drug intake in the sildenafil group compared to the placebo group (p < 0.05). Conclusion: Sildenafil causes a significant increase in blood flow in these arteries. A possible role of inhibition of phosphodiesterase-5 in vascular smooth muscles by sildenafil is implicated. Further studies are needed to investigate the effects of sildenafil on ocular blood flow in patients with senile macular degeneration, diabetic retinopathy and glaucoma.

After strabismus surgery on the horizontal recti, there are some alterations in the retrobulbar blood flow with a significant difference between pre- and postoperative blood flow velocities after single and double rectus surgery. The clinical significance of these results needs to be determined because CDI may be a useful tool in the investigation of hemodynamic alterations after anterior segment interventions that may cause anterior segment ischemia.

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Purpose: To investigate the effects of anisometropia on binocular function and the relationship between stereopsis and fusion in anisometropia. Methods: Twenty-five patients with anisometropia were studied. The manifest refraction and bestcorrected Snellen visual acuity of each patient was recorded. Patients, corrected with spectacles, were evaluated using Bagolini glasses, the 4diopter (D) prism test, Worth four-dot test, and TNO stereotest. Results: All patients indicated fusion by the Bagolini glasses. Although the 4-D prism test was positive in the anisometropic eye of all 25 patients, it was slower than the response of the other eye in 1 9 patients with reduced stereoacuity. On the distant Worth four-dot test, fusion response was positive in 1 5 patients. On the TNO test, stereoacuity levels were reduced or absent in 19 patients. Conclusion: The depth of amblyopia is more effective than the amount of anisometropia in causing a deterioration in binocularity. Even if fusion is weak, almost all patients with anisometropia have bifoveal fusion. Fusion becomes weak and stereoacuity decreases in proportion to the anisometropic amblyopia. Stereoacuity is related to the strength of fusion, and the TNO stereotest effectively detects those patients with significant anisometropic amblyopia. Journal of Pediatric Ophthalmology and Strabismus 2001;38:27-33.

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