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David Y. Kim, R.V. Paul Chan, Aziz A. Khanifar, Harriet Lloyd, Yena Ryu, Peter Schlegel, Ronald H. Silverman, D. Jackson Coleman; Digital Ultrasound And Optical Coherence Tomography-guided Measurement Of Choroidal Perfusion And Thickness Following Systemic Sildenafil. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2133.
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To demonstrate anatomic and flow changes in the human choroid following systemic sildenafil citrate (Viagra®) using enhanced depth imaging spectral domain-optical coherence tomography (EDI-OCT) and swept-scan high frequency digital ultrasound.
Seven healthy male subjects (mean age 32.7 years) were evaluated at baseline and two hours after ingesting 50 mg of sildenafil. Choroidal perfusion measurements were made using swept-scan high frequency digital ultrasound. Choroidal thickness measurements were made using EDI-OCT. Results were read by masked observers. One patient underwent fluorescein angiography. The Wilcoxon signed-rank test and paired t-test were used to analyze differences in choroidal flow and thickness at baseline and two hours after ingestion of sildenafil.
Two hours following sildenafil, increased choroidal perfusion was observed in 11 of 12 eyes measured by swept-scan high frequency digital ultrasound (Figures A-D). The mean increase was 3.46 (±2.00) times baseline with a range of 0.47 to 7.80 times baseline (p=0.004). Choroidal thickness measured with EDI-OCT showed increased thickness for all eyes (Figures E-F). The average choroidal thickness for all eyes increased by 11.6% temporal to the fovea, 9.3% nasal to the fovea, and 10.7% underneath the fovea (p<0.001 for all values). Fluorescein angiography showed no significant variation in fill time or vessel caliber.
This study demonstrates an increase in choroidal perfusion and thickness in response to sildenafil. These changes could secondarily affect retinal function, explain previously reported clinical symptoms, and potentially be a useful adjunct for treatment of ocular diseases that would benefit from increased choroidal blood flow.
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