TOPLINE:

Men with erectile dysfunction (ED) who used sildenafil had a higher risk for serous retinal detachment than those who did not use the drug, a new study finds.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to assess whether the use of sildenafil was associated with an increased risk for serous retinal detachment in men with ED.
• They included men aged 18 years or older with ED, identified using electronic health records from a database spanning more than 70 US health systems.
• Men who used sildenafil were propensity score-matched with those who did not use the drug, resulting in 208,930 patients in each cohort (mean ages, 56.9 and 56.6 years, respectively).
• The primary outcome was the incidence of serous retinal detachment within 1 year. Secondary outcomes were retinal vascular occlusion and ischemic optic neuropathy.

TAKEAWAY:

• Men who used sildenafil had a 54% higher risk for serous retinal detachment than those who did not use the drug (risk ratio, 1.54; 95% CI, 1.08-2.20).
• Absolute rates of serous retinal detachment remained low — 0.04% over 1 year in men who used sildenafil and 0.02% in nonusers.
• The use of sildenafil was not associated with an increased risk for retinal vascular occlusion or ischemic optic neuropathy.

IN PRACTICE:

“Our results extend prior claims-based signals of an association between” phosphodiesterase type 5 (PDE5) inhibitors and serous retinal detachment, the researchers reported. “PDE5 inhibition has been hypothesized to alter choroidal blood flow and vascular permeability, which might help explain the association with serous retinal detachment,” they added.

The absence of associations with retinal vascular occlusion and ischemic optic neuropathy suggest sildenafil’s ocular risks may be specific to serous retinal pathology rather than ischemic events affecting the vessels or optic nerve, they wrote.

SOURCE:

The study was led by Jaffer Shah of Weill Cornell Medicine in New York City. It was published online on February 21 in Eye.

LIMITATIONS:

The use of electronic health records may have introduced residual confounding and misclassification of the use of sildenafil.

DISCLOSURES:

No funding source was explicitly mentioned for the study. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.