The Association Between Phosphodiesterase Type 5 Inhibitor Use and Risk of Non-Arteritic Anterior Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis. Issue 3 (5th June 2018)

• Record Type: Journal Article
• Authors: Liu, Bing; Zhu, Linxin; Zhong, Jingxiang; Zeng, Guohua; Deng, Tuo
• Is Part Of: Sexual medicine. Volume 6:Issue 3(2018)
• Page Start: 185
• Page End: 192
• Publication Date: 2018-06-05
• Subjects: Association -- Meta-Analysis -- Non-Arteritic Anterior Ischemic Optic Neuropathy -- Phosphodiesterase Type 5 Inhibitors -- Systematic Review; Sexual disorders -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1016/j.esxm.2018.03.001
• Languages: English
• ISSNs: 2050-1161

Abstract

Abstract: Introduction: Phosphodiesterase type 5 inhibitors (PDE5-Is) are first-line drugs for erectile dysfunction. Non-arteritic anterior ischemic optic neuropathy (NAION) has been linked with PDE5-I use. However, no meta-analysis or conclusive review has explored the association between NAION and PDE5-I use. Aim: To investigate the association between PDE5-I use and risk of NAION. Methods: A comprehensive literature search was conducted using online databases in October 2017 to obtain studies researching the association between PDE5-I application and occurrence of NAION. Summarized unadjusted risk ratios (RRs) with 95% CIs were calculated for the strength of this association. This study was conducted in accordance to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and registered in PROSPERO under number CRD42017080865. Main Outcome Measures: The strength of association between PDE5-I use and risk of NAION was assessed through pooled unadjusted RRs and 95% CIs. Results: 5 original articles with 6 clinical observations were included in the meta-analysis. No significant higher risk of NAION was observed after the use of PDE5-Is within a 1-month period (RR = 1.16, 95% CI = 0.98-1.39, P = .09). Subgroup analyses indicated 2 PDE5-Is were significantly related to NAION (tadalafil: RR = 2.14, 95% CI = 1.20–3.84, P = .01; sildenafil: RR = 2.25, 95% CI = 1.29–3.94, P = .004). Conclusions: Although we found no association between NAION and PDE5-I use, our results should be interpreted cautiously because we included only observational studies and could not control for potential confounders. Because NAION is a rare ocular disease and difficult to diagnose, this association should be confirmed in prospective comparative studies with larger samples and more rigorous designs.