Measurement of choroidal perfusion and thickness following systemic sildenafil (Viagra)

Kim, David Y.; Silverman, Ronald H.; Chan, Robison Vernon Paul; Khanifar, Aziz A.; Rondeau, Mark; Lloyd, Harriet O.; Schlegel, Peter; Coleman, Donald Jackson

Purpose: To demonstrate anatomic and physiologic 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. Methods: Seven healthy male subjects (mean age 32.7 years) were evaluated at baseline and 2 hr after ingesting 50 mg of sildenafil. Swept-scan high-frequency digital ultrasound and EDI-OCT were utilized to measure choroidal perfusion and thickness, respectively. Results were read by masked observers. The Wilcoxon signed-rank test and t-test were used to analyse differences in choroidal flow and thickness at baseline and 2 hr after ingestion of sildenafil. Results: Two hours following sildenafil, increased choroidal perfusion was observed in 11 of 12 eyes measured by swept-scan high-frequency digital ultrasound. The mean increase was 3.46 (±2.00) times baseline with a range of 0.47–7.80 times baseline (p = 0.004). Increased choroidal thickness was observed in 12 of 12 eyes measured with EDI-OCT. The average choroidal thickness 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). Conclusions: Choroidal perfusion and thickness both increase in response to systemic 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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Acta Ophthalmologica

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Center for Digital Research and Scholarship, Columbia University
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November 13, 2013