Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

Abstract EN

Purpose.

To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction.

Methods.

Observational case report.

Results.

A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion.

A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intravenously, followed by oral prednisone 75 mg/d.

Final visual acuity was 20/50 right eye (OD) and 20/20 left eye (OS).

He had preexisting diabetes.

Conclusion.

This is the first reported case of simultaneous bilateral NAION occurred in a diabetic patient early after Sildenafil intake.

Patients with predisposing conditions such as diabetes have to be warned against the use of PDE inhibitors.