Background
Abnormal vision has been reported by 3% of patients treated with sildenafil citrate (Viagra). Although many men use
Viagra for an extended period for treatment of erectile dysfunction, the implications of the long term-daily use of it on
the retina and optic nerve are unclear.
Aim of the work
To investigate the effect of chronic daily use of sildenafil citrate in a dose equivalent to men preferred therapeutic
dose on the histology of the retina and optic nerve of adult male rat.
Material & methods
Eighteen adult male Wistar rats were equally divided into three groups. Group I: control. Group II: treated with sildenafil
citrate orally (10 mg/kg/day) for 8 weeks. Group III (withdrawal): treated as group II and then left for 4 weeks without
treatment. Specimens from the retina and optic nerve were processed for light and electron microscopy.
Results
In sildenafil citrate treated group, the retina and optic nerve revealed vacuolations and congested blood capillaries
with apoptotic endothelial and pericytic cells, and thickened basal lamina. Caspase-3 (apoptotic marker) and CD31 (endothelial
marker) expression increased. Glial cells revealed morphological changes: Müller cells lost their processes,
activated microglia, astrocytic clasmatodendrosis, degenerated oligodendrocytes surrounded by disintegrated myelin
sheathes of the optic nerve fibers. The retina and optic nerve of the withdrawal group revealed less vacuolations and congestion,
and partial recovery of the glial cells.
Conclusion
Chronic treatment with sildenafil citrate (Viagra) caused toxic effect on the structure of the retina and optic nerve of
the rat. Partial recovery was observed after drug withdrawal.