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Neurol Clin. 2017 Feb;35(1):17-27. doi: 10.1016/j.ncl.2016.08.007.

Erectile Dysfunction Agents and Nonarteritic Anterior Ischemic Optic Neuropathy.

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Department of Ophthalmology, Northwell Health, 600 Northern Boulevard, Suite 214, Great Neck, NY 11021, USA. Electronic address:


Phosphodiesterase-5 inhibitors (PDE5I) are used for treatment of erectile dysfunction and pulmonary arterial hypertension and have been implicated as a causative factor for development of nonarteritic anterior ischemic optic neuropathy (NAION). Controversy remains regarding a cause and effect between PDE5I use and NAION because the mechanism by which NAION occurs is still not well understood. Because neuro-ophthalmologists have accepted that there is a potential relationship between ingestion of the PDE5I class of medications and NAION, the neuro-ophthalmologist should inquire about PDE5I use when evaluating a patient with a new diagnosis of NAION, and counsel patients regarding the implication of continued use of PDE5I.


Erectile dysfunction drug; Non-arteritic anterior ischemic optic neuropathy; Pfizer; Phosphodiesterase 5 inhibitor; Sildenafil; Tadalafil; Vardenafil

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