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D Jackson Coleman, Winston Lee, Stanley Chang, Suzanne Daly, Harriet O Lloyd, Stephen H Tsang; Systemic PDE 5/6 treatment of macular disease and dystrophy – long term vision and OCT results. Invest. Ophthalmol. Vis. Sci. 2018;59(9):69. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate inhibition of PDE 5/6 with sildenafil to reduce choroidal ischemia and treat age-related macular degeneration, retinitis pigmentosa and central serous retinopathy.
In a series of 10 patients in an IRB-approved study at Columbia University Medical Center, sildenafil was prescribed to treat participants with macular disease. Spectral Domain-Optical Coherence Tomography (OCT), color fundus photography, Enhanced Depth Imaging-OCT and Best Corrected Visual Acuity (BCVA) data were acquired.
No loss of vision was noted after 30 months follow up for most patients. No change to calcified drusen was noted. Vitelliform-type soft drusen were not substantially changed. A patient with Best vitelliform macular dystrophy had a significant improvement in vision and photoreceptor and ellipsoid layers, and a patient with central serous retinopathy showed early and significant improvement.
Our research supports the use of sildenafil as a safe treatment for age-related and vitelliform macular degenerations. Thickened Bruch’s membrane reduces the beneficial effect of perfusion-increase, but all eyes appear to benefit from PDE6 inhibition. Notably, the maintenance or improvement in the photoreceptor layer may be the most significant result of sildenafil and is consistent with PDE6 inhibition. Central serous retinopathy shows early and complete resorption of serous fluid.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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