Galvez-Ruiz Alberto, Arishi Nawal
Division of Neuro-Ophthalmology, King Khaled Eye Specialist Hospital, Saudi Arabia.
Saudi J Ophthalmol. 2013 Oct;27(4):241-6. doi: 10.1016/j.sjopt.2013.07.010. Epub 2013 Jul 22.
AIM/PURPOSE: To present a summary of 10 cases of non-arteritic anterior ischemic optic neuropathy (NAION) in patients who received phosphodiesterase type 5 (PDE-5) inhibitors.
A case series of 10 patients who, after regular intake of Sildenafil, presented with a first episode of NAION in one eye. NAION was diagnosed based on the following criteria: acute, painless, unilateral loss of vision, fundus features consistent with NAION and exclusion of other possible causes.
Despite the initial adverse event (first episode of NAION), all of these patients continued to use the medication and developed a second episode of NAION in the contralateral eye. Only one of the 10 patients presented with bilateral simultaneous NAION.
This largest case series published to date, reinforces the general consensus that PDE-5 inhibitors are contraindicated in patients with a history of unilateral NAION.
总结10例服用5型磷酸二酯酶（PDE-5）抑制剂的患者发生非动脉炎性前部缺血性视神经病变（NAION）的情况。
对10例患者进行病例系列研究，这些患者在规律服用西地那非后，单眼首次发生NAION。NAION的诊断基于以下标准：急性、无痛性、单眼视力丧失、眼底特征符合NAION且排除其他可能原因。
尽管最初出现了不良事件（首次发生NAION），但所有这些患者仍继续使用该药物，且对侧眼发生了第二次NAION。10例患者中仅1例出现双侧同时发生的NAION。
该迄今为止发表的最大病例系列研究，强化了普遍共识，即有单侧NAION病史的患者禁用PDE-5抑制剂。
