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  • Phosphodiesterase 5 Inhibitors and Ocular Adverse Events

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, May 2022

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    Etminan et al. sought to quantify the risk of serous retinal detachment (SRD), retinal vascular occlusion (RVO), and ischemic optic neuropathy (ION) in men taking phosphodiesterase type 5 inhibitors. They found that regular us­ers of these drugs, which are commonly prescribed for erectile dysfunction, might be at increased risk of SRD, RVO, and ION.

    The researchers used the PharMetrics Plus database for this cohort study and the nested case-control analysis. Main outcomes included first diagnosis of SRD, RVO, or ION.

    The cohort consisted of 213,033 men; of these, 123,347 used sildenafil, 78,609 used tadalafil, 6,604 took vardenafil, and 4,473 took avanafil. The case-control analysis included 4,584 controls and 1,146 cases of SRD (n = 278), RVO (n = 628), and ION (n = 240). The mean age of both groups was 64.6 years. Patients with SRD, RVO, and ION were more likely than those in the control group to have hypertension, diabetes, cardiovascular disease, or sleep apnea.

    Further research is needed to elu­cidate the mechanisms behind these associations, the authors note. In the interim, they emphasize that individ­uals who regularly take these drugs should be aware of the risk of ocular adverse events and alert their physicians if they experience any visual deficits. (Also see related commentary by Brian L. VanderBeek, MD, MPH, MSCE, and Maureen G. Maguire, PhD, in the same issue.)

    The original article can be found here.