Sildenafil Use and Nonarteritic Ischemic Optic Neuropathy Risk
Risk Assessment and Evidence
- The American College of Physicians suggests that very-low-quality evidence exists regarding the association between PDE-5 inhibitors and NAION, making it difficult to establish a definitive causal relationship 1, 2, 3
- A study of 4 million veterans aged 50 years or older showed PDE-5 inhibitors were not significantly associated with confirmed NAION (relative risk 1.02 [95% CI, 0.92 to 1.12]) 1, 4
- PDE-5 inhibitors were associated with an increased risk for "possible NAION" (relative risk 1.34 [CI, 1.17 to 1.55]) 1, 5
- Patients over 50 years old with diabetes 1 and smoking history 5 are at increased risk of NAION when using PDE-5 inhibitors 5