Which ocular condition has been associated with PDE-5 inhibitors?

Which ocular condition has been associated with PDE-5 inhibitors?

• A. NAION
• B. PSC cataract formation
• C. Photophobia
• D. Floaters

Answer: (A)

The important concept is that PDE-5 inhibitors have been linked to non-arteritic anterior ischemic optic neuropathy, NAION. NAION is a sudden, painless vision loss in one eye caused by reduced blood flow to the optic nerve head. PDE-5 inhibitors can cause systemic vasodilation and sometimes a drop in blood pressure; in people with vascular risk factors or a small optic nerve head, this may transiently lower optic nerve perfusion enough to trigger NAION. There are postmarketing reports of NAION occurring with sildenafil, tadalafil, and vardenafil, which is why this association is noted and why caution is advised in at‑risk patients. The other options are not recognized ocular effects linked to PDE-5 inhibitors. PSC cataracts, photophobia, and floaters may occur for various reasons, but they are not strongly associated with these drugs. If sudden vision loss occurs while using a PDE-5 inhibitor, seek urgent eye evaluation.

The important concept is that PDE-5 inhibitors have been linked to non-arteritic anterior ischemic optic neuropathy, NAION. NAION is a sudden, painless vision loss in one eye caused by reduced blood flow to the optic nerve head. PDE-5 inhibitors can cause systemic vasodilation and sometimes a drop in blood pressure; in people with vascular risk factors or a small optic nerve head, this may transiently lower optic nerve perfusion enough to trigger NAION. There are postmarketing reports of NAION occurring with sildenafil, tadalafil, and vardenafil, which is why this association is noted and why caution is advised in at‑risk patients.

The other options are not recognized ocular effects linked to PDE-5 inhibitors. PSC cataracts, photophobia, and floaters may occur for various reasons, but they are not strongly associated with these drugs. If sudden vision loss occurs while using a PDE-5 inhibitor, seek urgent eye evaluation.