Korean J Ophthalmol.  2012 Jun;26(3):235-238. 10.3341/kjo.2012.26.3.235.

Anterior Ischemic Optic Neuropathy Associated with Udenafil

• Kim IG
• Kim DY

• KMID: 1376133
• DOI: http://doi.org/10.3341/kjo.2012.26.3.235

Abstract

We report a case of anterior ischemic optic neuropathy associated with udenafil. A 54-year-old male presented with an acute onset visual field defect of the right eye after udenafil use. Examination revealed a relative afferent pupillary defect and a swollen disc. Automated visual fields revealed an enlarged blind spot and a narrowed visual field. Fluorescein angiography revealed both an inferior choroidal filling delay and an inferior sector filling delay of the optic disc in the arteriovenous phase as well as diffuse leakage of the optic disc in the late phase. Optical coherent tomography revealed increased thickness of the retinal nerve fiber layer, especially in the area of the inferior disc. The patient was counseled to discontinue the use of udenafil and to monitor his blood pressure regularly. The disc swelling was resolved with residual optic atrophy one month after discontinuing the use of udenafil.

Keyword

Anterior ischemic optic neuropathy; Erectile dysfunction; Udenafil

MeSH Terms

Acute Disease
Choroid/*pathology
Humans
Male
Middle Aged
Optic Neuropathy, Ischemic/*chemically induced/diagnosis
Phosphodiesterase 5 Inhibitors/adverse effects
Pyrimidines/*adverse effects
Sulfonamides/*adverse effects
Tomography, Optical Coherence
Visual Fields

Figure

• 

  Fig. 1 (A) Fundus photograph of the right eye shows prominent swelling of the disc with a disc rim hemorrhage. (B) Fundus photograph of the left eye shows a healthy appearing but crowded disc with a cup-to-disc ratio of 0.2.

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  Fig. 2 Fluorescein angiography shows an inferior choroidal filling delay and inferior sector filling delay of the optic disc in the arteriovenous phase (A) as well as diffuse leakage of the optic disc in the late phase (B).

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  Fig. 3 Humphrey 30-2 visual field of the left (A) and right eyes (B) at the initial examination.

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  Fig. 4 Ocular coherence tomography shows prominent thickening of the retinal nerve fiber layer of the right eye. TEMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = right eye; OS = left eye.

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