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Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction

¹ Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
² Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence to:
Correspondence to:
Dr Gerald McGwin Jr
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, 700 S 18th Street, Suite 609, Birmingham, AL 35294-0009, USA; mcgwin{at}uab.edu

Aim: To determine the association between Viagra (sildenafil) and Cialis (tadalafil) and non-arteritic anterior ischaemic optic neuropathy (NAION).

Methods: A retrospective matched case-control study was conducted. 38 cases of NAION in males were identified from an academic ophthalmology practice in Birmingham, Alabama, and matched (on age) to 38 controls without a history of NAION. Self reported information regarding past and current use of Viagra and/or Cialis was obtained via a telephone questionnaire from interviewers who were not blind to case status.

Results: Overall, males with NAION were no more likely to report a history of Viagra or Cialis use compared to similarly aged controls (odd ratio (OR) 1.75, 95% confidence interval (CI) 0.48 to 6.30 and OR 1.82, 95% CI 0.21 to 15.39). However, for those with a history of myocardial infarction, a statistically significant association was observed (OR 10.7, 95% CI 1.3 to 95.8). A similar association was observed for those with a history of hypertension though it lacked statistical significance (OR 6.9, 95% CI 0.8 to 63.6).

Conclusions: For men with a history of myocardial infarction or hypertension the use of Viagra or Cialis may increase the risk of NAION. Physicians prescribing these medications to patients with these conditions should warn them about the potential risk of NAION.

Abbreviations: ED, erectile dysfunction; NAION, non-arteritic anterior ischaemic optic neuropathy

Keywords: non-arteritic anterior ischaemic optic neuropathy

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