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

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

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Purpose.To describe a patient who Note Cards 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 Clothing - Womens Tops - Sleeveless 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.