Anterior ischemic optic neuropathy and stroke with use of PDE-5 inhibitors for erectile dysfunction: Cause or coincidence?

Carter, John E.

doi:10.1016/j.jns.2007.06.018

Cited by 34 publications

(23 citation statements)

References 76 publications

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“…Since its FDA approval to treat men with erectile dysfunction, sildenafil has become one of the most popular drugs worldwide [3]. Sildenafil was recently approved by the FDA for use in patients with pulmonary hypertension [7,8,36].…”

Section: Discussion and Analysismentioning

confidence: 99%

“…Sildenafil (Viagra R ) is an inhibitor of PDE type 5 (PDE5) and to a lesser degree PDE type 6 (PDE6). It was first approved by the Food and Drug Administration (FDA) for use in men with erectile dysfunction on March 27, 1998 [3]. As of August 2008, sildenafil has been prescribed to more than 37 million men, and more than a billion tablets (averaging six per second) have been dispensed worldwide [4].…”

Section: Introductionmentioning

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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Section: Discussion and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…Such interventions include independent patients and physicians' exposure to a new commercial media campaigns in Israel on MayJune 2007 with the aim of raising the awareness towards ED, and studies that were published during and around the study period regarding rare, severe side effects of PDE5-inh medications. 8,9 However, these processes most probably acted in both groups in both ways, and thus it is hard to assess their influence over theses variables. ED diagnosis and medical treatment correlate with the patients' age, so that younger patients had a greater chance to be diagnosed with ED and to be given prescriptions for PDE5-inh.…”

Section: Discussionmentioning

confidence: 99%

Raising awareness for the diagnosis and treatment of erectile dysfunction in patients with high risk to develop ED

et al. 2009

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Prevalence of erectile dysfunction (ED) increases with age and is associated with chronic comorbidities, such as diabetes and hypertension. Even so, ED is underdiagnosed and undertreated. This study investigated the effect of raising awareness of ED diagnosis and treatment in a community setting by physicians' education. Thirty-nine primary care physicians participated in lectures by a trained sexologist, and 20 of them also received computerized lists of their high-risk patients. We matched a control group of 39 primary care physicians who did not receive the intervention; we thus followed 1959 patients in both intervention groups and 1903 patients in the control group. During the period of 6 months before the intervention and 6 months after the intervention, no significant differences were found between the groups in diagnosis of new ED patients, in phosphodiesterase-5 inhibitor prescriptions or in referrals to urologists. We therefore suggest that sporadic lectures and computerized patient lists do not significantly affect the physician's behavior.

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“…However, although transient visual symptoms are common and there also have been cases of nonarteritic anterior ischemic optic-neuropathy (NAION) in patients using these drugs, the evidence to support PDE-5i as a cause of any vascular event is weak (Carter, 2007). Thus, there is little basis for modifying the current guidelines for the use of these drugs.…”

Section: Sexuality and Stroke 603mentioning

confidence: 99%

Male Sexual Disorders Following Stroke: An Overview

Calabrò

Gervasi

Bramantı

2011

International Journal of Neuroscience

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Stroke is one of the leading causes of death and disability throughout the world. Although physical and cognitive impairments after stroke have been well studied, little information is known about one of the crucial aspect of the quality of life of stroke patients, namely, sexual functioning and satisfaction. Poststroke sexual dysfunctions seem to be very common since in men affected by stroke, a decline in libido and poor or tailed erection and ejaculation are frequently observed. Sexual disorders after stroke are thought to be due to multiple etiologies, including both organic (i.e., lesion localization, premorbid medical conditions, and medications) and psychosocial (i.e., fear of recurrences, loss of self-esteem, role changes, anxiety, and depression). Thus, exploration in sexual dysfunctions and sexual counseling by trained professionals should be a part of stroke rehabilitation. The aim of this review is to evaluate the burden of stroke on sexual function taking into account the complex interaction between neurological, psychological, and relational factors.

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Anterior ischemic optic neuropathy and stroke with use of PDE-5 inhibitors for erectile dysfunction: Cause or coincidence?

Cited by 34 publications

References 76 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

Raising awareness for the diagnosis and treatment of erectile dysfunction in patients with high risk to develop ED

Male Sexual Disorders Following Stroke: An Overview

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