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Phosphodiesterase type 5 inhibitor use may increase risk of ocular adverse events

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The regular use of phosphodiesterase type 5 inhibitors (PDE5Is) may lead to an increased risk for serious retinal detachment (SRD), retinal vascular occlusion (RVO), and ischemic optic neuropathy (ION), according to a study published in JAMA Ophthalmology. People who regularly take PDE5Is should be made aware of the potential for ocular adverse events.

In this cohort study, data on 213,033 men receiving PDE5Is was collected until the first diagnosis of SRD, RVO, or ION or termination of insurance coverage.

Overall, there were 278 cases of SRD, 628 of RVO, and 240 of ION. The 1146 total cases were matched to 4584 controls. The mean (SD) age in both groups was 64.6 (13.3) years.

Hypertension, diabetes, coronary artery disease, and sleep apnea were more likely in patients with SRD, RVO, and ION.

For any of the 3 outcomes, the adjusted incidence rate ratios (IRRs) was 1.85 (95% CI, 1.41-2.42; incidence, 15.5 cases per 10,000 person-years). The adjusted IRR for SRD was 2.58 (95% CI, 1.55-4.30; incidence, 3.8 cases per 10 000 person-years); for RVO was 1.44 (95% CI, 0.98-2.12; incidence, 8.5 cases per 10 000 person-years); and for ION was 2.02 (95% CI, 1.14-3.58; incidence, 3.2 cases per 10 000 person-years).

Etminan M, Sodhi M, Mikelberg FS, et al. Risk of Ocular Adverse Events Associated With Use of Phosphodiesterase 5 Inhibitors in Men in the US. JAMA Ophthalmol.  2022;doi:10.1001/jamaophthalmol.2022.0663