Metelitsina Tatyana I, Grunwald Juan E, DuPont Joan C, Ying Gui-Shuang, Liu Chengcheng
Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA.
Exp Eye Res. 2006 Jul;83(1):128-32. doi: 10.1016/j.exer.2005.11.012. Epub 2006 Mar 10.
The aim of the present study was to investigate the effect of sildenafil citrate (viagra) on retinal venous diameter in patients with age-related macular degeneration (AMD). We investigated 14 male patients in a double-masked, randomized, placebo-controlled, crossover study. In each subject, one eye with typical non-exudative AMD fundus features was studied. Each of the subjects received 100 mg dose of sildenafil or matching placebo on two separate study visits. Monochromatic fundus photographs were obtained in the study eye before dosing and then 30, 90, 180 and 300 min later. Measurements of the diameter of the major retinal veins from digitized negatives were carried out using "Vessel map" static vessel analysis program (IMEDOS GmbH, Weimar, Germany). Statistical analysis of the data comparing the effect of sildenafil and placebo on venous diameters was performed using analysis of variance (ANOVA) for repeated measures. An analysis of variance (ANOVA) comparing the effects of sildenafil citrate and placebo on retinal vein diameters showed a significant interaction between time and treatment (P = 0.03). In comparison to placebo, sildenafil citrate produced a statistically significant vasodilatation of major retinal veins of 4.7% at 90 min (P = 0.004), 5.5% at 180 min (P < 0.0001) and 5.8% at 300 min (P < 0.0001). At 30 min there was a 2.2% difference, which was not statistically significant (P=0.14). Our results suggest that in patients with age-related macular degeneration, sildenafil citrate (viagra) produces a statistically significant vasodilatation of major retinal veins that is similar to what has been reported in normal subjects. Whether this vasodilatation is associated with changes in retinal blood flow needs to be further investigated.
本研究的目的是调查枸橼酸西地那非（伟哥）对年龄相关性黄斑变性（AMD）患者视网膜静脉直径的影响。我们在一项双盲、随机、安慰剂对照、交叉研究中调查了14名男性患者。对每个受试者一只具有典型非渗出性AMD眼底特征的眼睛进行研究。每个受试者在两次单独的研究访视中分别接受100毫克剂量的西地那非或匹配的安慰剂。在给药前以及给药后30、90、180和300分钟，对研究眼拍摄单色眼底照片。使用“血管图”静态血管分析程序（德国魏玛的IMEDOS GmbH公司）对数字化底片上的主要视网膜静脉直径进行测量。使用重复测量方差分析（ANOVA）对比较西地那非和安慰剂对静脉直径影响的数据进行统计分析。比较枸橼酸西地那非和安慰剂对视网膜静脉直径影响的方差分析（ANOVA）显示时间和治疗之间存在显著交互作用（P = 0.03）。与安慰剂相比，枸橼酸西地那非在90分钟时使主要视网膜静脉产生具有统计学意义的血管扩张，扩张率为4.7%（P = 0.004），在180分钟时为5.5%（P < 0.0001），在300分钟时为5.8%（P < 0.0001）。在30分钟时差异为2.2%，无统计学意义（P = 0.14）。我们的结果表明，在年龄相关性黄斑变性患者中，枸橼酸西地那非（伟哥）使主要视网膜静脉产生具有统计学意义的血管扩张，这与正常受试者中所报道的情况相似。这种血管扩张是否与视网膜血流变化相关需要进一步研究。
