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Sildenafil in ophthalmology: An update.

Supriya Arora1, Thamolwan Surakiatchanukul2, Tarun Arora1

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Summary

Sildenafil citrate, used for erectile dysfunction, impacts ocular hemodynamics and retinal cells. This review explores its potential benefits and risks for eye conditions like macular degeneration and glaucoma.

Keywords:
Age related macular degenerationCentral serous chorioretinopathyChoroidal perfusionChoroidal thicknessErectile dysfunctionPhosphodiesterase inhibitorRetinitis pigmentosaSildenafilViagra

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Retinal Science

Background:

  • Sildenafil citrate is a phosphodiesterase 5 inhibitor primarily used for erectile dysfunction.
  • It exhibits partial inhibition of phosphodiesterase 6 (PDE6), an enzyme crucial for retinal phototransduction.
  • Emerging research highlights sildenafil's effects on ocular hemodynamics and retinal cellular function.

Purpose of the Study:

  • To review the influence of sildenafil on ocular hemodynamics, including choroidal perfusion and thickness.
  • To discuss the drug's impact on retinal cells, such as bipolar cells and cyclic-nucleotide gated channels.
  • To explore potential beneficial and deleterious ocular effects and drug interactions of sildenafil.

Main Methods:

  • Literature review of studies on sildenafil's ocular effects.
  • Analysis of research on ocular imaging, hemodynamics, and retinal cell function.
  • Discussion of clinical observations and potential mechanisms of action.

Main Results:

  • Sildenafil increases choroidal thickness and enhances choroidal perfusion through autoregulatory mechanisms.
  • The drug influences intraocular pressure via increased choroidal volume and blood flow to the ciliary body.
  • Sildenafil affects retinal bipolar cells and cyclic-nucleotide gated channels, with implications for phototransduction.

Conclusions:

  • Sildenafil has complex effects on ocular hemodynamics and retinal cells, with potential benefits and risks.
  • Potential adverse effects include central serous chorioretinopathy, glaucoma, and ischemic optic neuropathy.
  • Beneficial effects may include ameliorating choroidal ischemia and aiding recovery in macular degeneration, alongside considerations for drug interactions.