Association between PDE5 Inhibitors and Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION): A Descriptive Study

Objectives: Treatment by phosphodiesterase-5 (PDE-5) inhibitors for different medical illnesses in males has been reported to be a risk factor for development of non-arteritic anterior ischemic optic neuropathy (NAION). The objective was to review the relationship between PDE-5 inhibitors and the occurrence of NAION. Methods: This retrospective review descriptive research enrolled 532 male patients that used PDE-5 inhibitors. These patients were treated for erectile dysfunction in Jordanian Royal Medical Services between November 2020 and October 2024 for two periods of follow-up (30 days and 1 year). group1: patients with the use of PDE5Is for 30 days, group2: patients were given PDEIs for 1 year. Patients were aged between (46 and 78 years). Following variables were included in this research: NAION cases, underlying risk factor systemic disease, history of major surgery, and risk factor medications. Results: Regarding the demographic and categorical data no significant differences were observed except for the increase of the risk of NAION in group2 after prolonged use of PDE5Is > 30 days (group1 percentage of affected cases was 5.9%, while in group2 was 9.726%) (P value = 0.0492). Conclusion: NAION occurrence could be increased when treatment by PDE5Is last for a period more than one month. So, in contrast of other literatures that suggest no association between PDE5Is and occurrence of NAION, our study encourages further research to investigate the effect of these drugs on the circulation of the optic nerve head to decrease NAION possible cases.