Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba, 260-8677, Japan.
BMC Ophthalmol. 2022 May 12;22(1):216. doi: 10.1186/s12886-022-02426-7.
Few case reports have described sildenafil overdose, particularly ingestion of > 1000 mg, and overdose-induced changes in visual function remain unclear. We report retinal morphology, retinal sensitivity, and findings of electrophysiological evaluation over long-term follow-up in a case of sildenafil overdose (2000 mg).
Our patient developed visual abnormalities in the paracentral visual field accompanied by photophobia, decreased contrast sensitivity, and difficulty distinguishing colors in both eyes, 8 hours after the sildenafil overdose. These symptoms did not improve throughout the course, and although abnormalities of retinal morphology and sensitivity, as well as the electroretinogram findings showed slight improvement, the patient did not recover completely at 6-month follow-up.
We observed that high-dose sildenafil ingestion leads to retinal toxicity; the ocular abnormalities may persist for at least 6 months. Optical coherence tomography, Humphrey perimetry, microperimetry, and multifocal electroretinography are useful to quantitatively monitor temporal changes.
仅有少数病例报告描述了西地那非过量，特别是摄入 >1000 毫克，而过量引起的视觉功能改变仍不清楚。我们报告了一例西地那非过量（2000 毫克）的视网膜形态、视网膜敏感性和长期随访的电生理评估结果。
我们的患者在西地那非过量 8 小时后出现双眼旁中心视野的视觉异常，伴有畏光、对比敏感度下降和辨色困难。这些症状在整个过程中没有改善，尽管视网膜形态和敏感性的异常以及视网膜电图的发现显示出轻微改善，但在 6 个月的随访中患者并未完全恢复。
我们观察到高剂量西地那非摄入会导致视网膜毒性；眼部异常可能至少持续 6 个月。光学相干断层扫描、Humphrey 视野计、微视野计和多焦视网膜电图有助于定量监测时间变化。
