Central serous chorioretinopathy associated with sildenafil

Retina. 2008 Apr;28(4):606-9. doi: 10.1097/IAE.0b013e31815ec2c8.


Purpose: : To investigate a suspected relationship between central serous chorioretinopathy (CSC) and sildenafil therapy.

Methods: : For this retrospective, observational case series, the authors reviewed over 1,500 case reports of sildenafil-associated ocular side effects from the postmarketing surveillance databases of the Food and Drug Administration (FDA), the World Health Organization (WHO), and the National Registry of Drug-Induced Ocular Side Effects. They also performed a Medline literature search for "retinopathy, retinal edema, macular edema" (terms associated with CSC) and "sildenafil." They identified 11 cases of CSC in men taking sildenafil.

Results: : In 8 of 11 cases, patients stopped sildenafil therapy when CSC occurred. In 6 of these 8 cases, patients' vision improved after sildenafil cessation. In 3 cases, effects recurred when patients resumed sildenafil therapy, but stopping therapy was not associated with improvement of CSC in every case. Two patients continued to experience CSC after sildenafil cessation.

Conclusion: : Practitioners who see patients with refractory CSC should consider recommending cessation of sildenafil therapy; however, because of the cyclic nature of CSC, a causal relationship has not yet been established. Additional possible case reports can be sent to the National Registry of Drug-Induced Ocular Side Effects, the FDA, the WHO, or the manufacturer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 3',5'-Cyclic-GMP Phosphodiesterases / antagonists & inhibitors
  • Adult
  • Aged
  • Choroid Diseases / chemically induced*
  • Databases, Factual
  • Humans
  • Male
  • Middle Aged
  • Phosphodiesterase Inhibitors / adverse effects*
  • Piperazines / adverse effects*
  • Product Surveillance, Postmarketing
  • Purines / adverse effects
  • Retinal Diseases / chemically induced*
  • Retrospective Studies
  • Serum
  • Sildenafil Citrate
  • Sulfones / adverse effects*


  • Phosphodiesterase Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Sildenafil Citrate
  • 3',5'-Cyclic-GMP Phosphodiesterases