PMID- 19624350
OWN - NLM
STAT- MEDLINE
DCOM- 20090930
LR  - 20160831
IS  - 1442-9071 (Electronic)
IS  - 1442-6404 (Linking)
VI  - 37
IP  - 5
DP  - 2009 Jul
TI  - Phosphodiesterase inhibitors and the eye.
PG  - 514-23
LID - 10.1111/j.1442-9071.2009.02070.x [doi]
AB  - Phosphodiesterase type 5 (PDE5) inhibitors are effective oral treatments for 
      erectile dysfunction and have become one of the most widely prescribed 
      medications worldwide. The mechanism of action is to reduce the degradation of 
      cyclic GMP (cGMP) potentiating the effect of nitric oxide in the corpus 
      cavernosum and allowing erectile function to occur by consequent relaxation of 
      penile smooth muscle. Because of the presence of PDE5 in choroidal and retinal 
      vessels these medications increase choroidal blood flow and cause vasodilation of 
      the retinal vasculature. The most common symptoms are a blue tinge to vision and 
      an increased sensitivity to light. There have been reports of non-arteritic 
      anterior ischaemic optic neuropathy and serous macular detachment in users of 
      PDE5 inhibitors, although a causal relationship has not been conclusively shown. 
      Despite the role of cGMP in the production and drainage of aqueous humour these 
      medications do not appear to alter intraocular pressure and are safe in patients 
      with glaucoma. All PDE5 inhibitors weakly inhibit PDE6 located in rod and cone 
      photoreceptors resulting in mild and transient visual symptoms that correlate 
      with plasma concentrations. Psychophysical tests reveal no effect on visual 
      acuity, visual fields or contrast sensitivity; however, some studies show a mild 
      and reversible impairment of blue-green colour discrimination. PDE5 inhibitors 
      transiently alter retinal function on electroretinogram testing but do not appear 
      to be retinotoxic. Despite the role of cyclic nucleotides in tear production 
      there is no detrimental effect on tear film quality. Based on the available 
      evidence PDE5 inhibitors have a good ocular safety profile.
FAU - Kerr, Nathan M
AU  - Kerr NM
AD  - Department of Ophthalmology, Faculty of Medical and Health Sciences, University 
      of Auckland, Auckland, New Zealand.
FAU - Danesh-Meyer, Helen V
AU  - Danesh-Meyer HV
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Australia
TA  - Clin Exp Ophthalmol
JT  - Clinical & experimental ophthalmology
JID - 100896531
RN  - 0 (Phosphodiesterase 5 Inhibitors)
RN  - 0 (Phosphodiesterase Inhibitors)
SB  - IM
MH  - Choroid/*blood supply
MH  - Color Vision/drug effects
MH  - Humans
MH  - Intraocular Pressure/drug effects
MH  - Optic Neuropathy, Ischemic/*chemically induced
MH  - *Phosphodiesterase 5 Inhibitors
MH  - Phosphodiesterase Inhibitors/adverse effects/*pharmacology
MH  - Regional Blood Flow/drug effects
MH  - Retinal Detachment/*chemically induced
MH  - Retinal Vessels/*physiology
MH  - Vasodilation/*drug effects
MH  - Visual Acuity/drug effects
MH  - Visual Fields/drug effects
RF  - 80
EDAT- 2009/07/25 09:00
MHDA- 2009/10/01 06:00
CRDT- 2009/07/24 09:00
PHST- 2009/07/24 09:00 [entrez]
PHST- 2009/07/25 09:00 [pubmed]
PHST- 2009/10/01 06:00 [medline]
AID - CEO2070 [pii]
AID - 10.1111/j.1442-9071.2009.02070.x [doi]
PST - ppublish
SO  - Clin Exp Ophthalmol. 2009 Jul;37(5):514-23. doi: 
      10.1111/j.1442-9071.2009.02070.x.