J Korean Ophthalmol Soc.  2018 Jan;59(1):93-97. 10.3341/jkos.2018.59.1.93.

A Case of Central Serous Chorioretinopathy after Tadalafil Treatment

• Yoon YS
• Lee S
• Woo JM
• Min JK

• KMID: 2401684
• DOI: http://doi.org/10.3341/jkos.2018.59.1.93

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.

Keyword

Central serous chorioretinopathy; Cialis®; Phosphodiesterase (PDE)-5 inhibitor; Tadalafil

MeSH Terms

Blood Vessels
Central Serous Chorioretinopathy*
Choroid
Diagnosis
Erectile Dysfunction
Follow-Up Studies
Humans
Male
Middle Aged
Retina
Retinal Pigment Epithelium
Subretinal Fluid
Tadalafil*
Vasodilator Agents
Vision Disorders
Visual Acuity
Tadalafil
Vasodilator Agents

Figure

• 

  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).

• 

  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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