Cunningham A V, Smith K H
Department of Surgery, Scott & White Memorial Hospital, Temple, Texas, USA.
J Neuroophthalmol. 2001 Mar;21(1):22-5. doi: 10.1097/00041327-200103000-00006.
A 42-year-old male presented with acute onset of an inferior visual field defect OD after sildenafil citrate use. Examination revealed a right relative afferent pupillary defect and a swollen disc with a 0.1 cup-to-disc ratio and a prominent disc hemorrhage. Anterior ischemic optic neuropathy (AION) is associated with acute episodes of hypotension in patients with structurally crowded discs. Sildenafil citrate may cause episodes of hypotension and was temporally related to the onset of symptoms in this patient. Because patients are often reluctant to volunteer their history of sildenafil citrate use, the physician may need to ask specifically about use of this medication. Physicians should counsel patients with crowded optic discs and a history of nonarteritic anterior ischemic optic neuropathy in one eye that use of sildenafil citrate might increase their risk of ischemic optic neuropathy in the fellow eye.
一名42岁男性在服用枸橼酸西地那非后急性出现右眼下方视野缺损。检查发现右侧相对性传入性瞳孔障碍，视盘肿胀，杯盘比为0.1，视盘有明显出血。前部缺血性视神经病变（AION）与视盘结构拥挤患者的急性低血压发作有关。枸橼酸西地那非可能导致低血压发作，且在该患者中与症状发作在时间上相关。由于患者通常不愿主动说出服用枸橼酸西地那非的病史，医生可能需要特别询问这种药物的使用情况。医生应告诫视盘拥挤且有一只眼非动脉性前部缺血性视神经病变病史的患者，使用枸橼酸西地那非可能会增加其另一只眼发生缺血性视神经病变的风险。
