Journal List > J Korean Ophthalmol Soc > v.59(1) > 1010917

Yoon, Lee, Woo, and Min: A Case of Central Serous Chorioretinopathy after Tadalafil Treatment

Abstract

Purpose

To describe a patient who presented with central serous chorioretinopathy after 2 months of tadalafil administration without any other underlying disease or medication.

Case summary

A 49-year-old male patient was transferred from a local clinic with metamorphopsia and decreased visual acuity in the right eye. His visual acuity was 6/20 in the right eye and 18/20 in the left eye. The fundus examination showed a large serous detachment between the superior and inferior blood vessel arcades in the right retina. In his medical history, he used tadalafil three times a week for 2 months. His medication was then stopped, and a follow-up examination was scheduled. After 2 months, a fundus examination showed resolution of the subretinal fluid, and his corrected visual acuity recovered to 20/20.

Conclusions

Tadalafil (Cialis®) is a phosphodiesterase (PDE)-5 inhibitor and predominantly prescribed for the treatment of erectile dysfunction. PDE–5 inhibitors may be potent vasodilators in the retina and choroid, and may induce choroidal vessel engorgement leading to leakage across the retinal pigment epithelium and accumulation of subretinal fluid in selected patients. When making a diagnosis as central serous chorioretinopathy, the physician should confirm the causative drugs that are easy to miss, by performing a thorough review of the patient's medical history and promptly terminating the causative drugs.

Figures and Tables

Figure 1

Baseline examination findings at the initial presentation. (A) Fundus photograph and (B) optical coherence tomography show a serous retinal detachment between upper and lower vessel arcades in the right eye (arrows). Fluorescein angiogram shows leaking at the upper nasal side (arrow) and hypofluorescence in serous retinal detachment area (C: 37 sec, D: 5 min 52 sec, E: 11 min 8 sec).

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Figure 2

Follow up of the optical coherence tomography (OCT). (A) A large amount of subretinal fluid was visible in the OCT at the first visit. (B) The amount of subretinal fluid decreased in the OCT after 1 week. (C) The amount of subretinal fluid significantly decreased in the OCT after 3 weeks. (D) Resolution of the serous retinal detachment was seen by OCT after 2 months.

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Notes

Conflicts of Interest The authors have no conflicts to disclose.

References

1. Haimovici R, Koh S, Gagnon DR, et al. Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004; 111:244–249.
2. Gemenetzi M, De Salvo G, Lotery AJ. Central serous chorioretinopathy: an update on pathogenesis and treatment. Eye (Lond). 2010; 24:1743–1756.
crossref
3. Laties AM. Vision disorders and phosphodiesterase type 5 inhibitors: a review of the evidence to date. Drug Saf. 2009; 32:1–18.
4. Türkcü FM, Yüksel H, Şahin A, et al. Central serous chorioretinopathy due to tadalafil use. Int Ophthalmol. 2013; 33:177–180.
crossref
5. Gordon-Bennett P, Rimmer T. Central serous chorioretinopathy following oral tadalafil. Eye (Lond). 2012; 26:168–169.
crossref
6. Aliferis K, Petropoulos IK, Farpour B, et al. Should central serous chorioretinopathy be added to the list of ocular side effects of phosphodiesterase 5 inhibitors? Ophthalmologica. 2012; 227:85–89.
crossref
7. Cordell WH, Maturi RK, Costigan TM, et al. Retinal effects of 6 months of daily use of tadalafil or sildenafil. Arch Ophthalmol. 2009; 127:367–373.
crossref
8. French DD, Margo CE. Central serous chorioretinopathy and phosphodiesterase-5 inhibitors: a case-control postmarketing surveillance study. Retina. 2010; 30:271–274.
9. Damar E, Toklu Y, Tuncel A, et al. Does therapeutic dose of sildenafil citrate treatment lead to central serous chorioretinopathy in patients with erectile dysfunction? Am J Mens Health. 2013; 7:439–443.
crossref
10. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015; 48:82–118.
crossref
11. Spaide RF, Goldbaum M, Wong DW, et al. Serous detachment of the retina. Retina. 2003; 23:820–846. quiz 895-6.
crossref
12. Yannuzzi LA, Slakter JS, Gross NE, et al. Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina. 2003; 23:288–298.
13. Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009; 29:1469–1473.
crossref
14. Melman A, Gingell JC. The epidemiology and pathophysiology of erectile dysfunction. J Urol. 1999; 161:5–11.
crossref
15. Lue TF. Impotence: a patient's goal directed approach to treatment. World J Urol. 1990; 8:67–74.
16. Goldstein I, Lue TF, Padma-Nathan H, et al. Sildenafil Study Group. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998; 338:1397–1404.
crossref
17. Laties AM, Zrenner E. Viagra (sildenafil citrate) and ophthalmology. Prog Retin Eye Res. 2002; 21:485–506.
crossref
18. Carter JE. Anterior ischemic optic neuropathy and stroke with use of PDE-5 inhibitors for erectile dysfunction: cause and coincidence? J Neurol Sci. 2007; 262:89–97.
19. Quiram P, Dumars S, Parwar B, Sarraf D. Viagra associated serous macular detachment. Graefes Arch Clin Exp Ophthalmol. 2005; 243:339–344.
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