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British Journal of Ophthalmology 2008;92:469-473; doi:10.1136/bjo.2007.131789
Copyright © 2008 by the BMJ Publishing Group Ltd.

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REVIEWS

The effect of sildenafil on ocular blood flow

A Harris1,2, L Kagemann3,4, R Ehrlich1, Y Ehrlich5, C R López1, V A Purvin1,6,7

1 Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
2 Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
3 UPMC Eye Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
4 Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
5 Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
6 Midwest Eye Institute, Indianapolis, IN, USA
7 Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA

Correspondence to:
A Harris, Department of Ophthalmology, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN 46202, USA; alharris{at}indiana.edu

Sildenafil is a potent phosphodiesterase (PDE) 5 inhibitor that is used for patients with erectile dysfunction. Sildenafil induces vasodilation in selected smooth muscle via increased levels of guanosine 3', 5' cyclic monophosphate and increase in nitric oxide. The vasodilatory effects of the PDE 5 inhibitors led us to review its effect on the ocular vasculature. Sildenafil appears to increase blood flow velocity significantly in the retrobulbar and choroidal circulation. Most studies suggest an increase in choroidal blood flow, with a lesser effect on the retinal vasculature.


Funding: Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc.

Competing interests: Five of the authors have no proprietary interest in any products or concepts mentioned in this article. AH is a consultant to Pfizer Inc.







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