Node Smith, ND
A case study from Mount Sinai was published recently that showed color vision problems resulting from cellular retinal damage from taking high doses of sildenafil citrate (Viagra).1 Viagra is a popular medication that is used to help men who suffer from erectile dysfunction get and maintain an erection. The case study demonstrates that prolonged, or excessive use of the medication could cause long-term vision issues, and potentially irreversible damage.
Study reveals the dangers behind a large dose of a commonly used medication
Lead investigator Richard Rosen, MD, Director of Retina Services at New York Eye and Ear Infirmary of Mount Sinai (NYEE), underlines a foundational consideration in prescribing these drugs when he comments, “[p]eople live by the philosophy that if a little bit is good, a lot is better. This study shows how dangerous a large dose of a commonly used medication can be.” He also offers that “[p]eople who depend on colored vision for their livelihood need to realize there could be a long-lasting impact of overindulging on this drug.”
Case study followed a 31-year-old male patient
The case study followed a 31-year-old male patient who presented to an urgent care clinic with symptoms of red-tinted vision in both eyes that had been persistent for two days. The symptoms had begun after taking a dose of liquid sildenafil citrate that he had purchased over the internet. The patient had consumed much more than the recommended 50mg dose – the normal dose range can cause visual disturbances, but symptoms usually resolve on their own within 24 hours.
Man diagnosed with persistent retinal toxicity
The man was diagnosed with persistent retinal toxicity related to the high dose of medication causing damage to the outer portion of the retina. The red-tinted visual complaints have still not improved after over a year.
Researchers used state-of-the-art technology
Mount Sinai researchers used state-of-the-art technology, including adaptive optics (AO) and optimal coherence tomography (OCT), to examine his retina for evidence of structural damage at the cellular level, something that had never been done before. AO is a sophisticated technology that allows clinicians to examine microscopic structures of the eye in living patients with extreme detail in real time. OCT is an advanced imaging system that reveals the cross-sectional details of the retina layer by layer.
Microscopic injury to the cones of the retina were assessed
Using these imaging techniques, microscopic injury to the cones of the retina were able to be assessed – cones are what allows for color vision. The damage was similar to other retinal diseases such as retinitis pigmentosa or cone-rod dystrophy.
Source:
- Yanoga F, Gentile RC, Chui TYP, et al. SILDENAFIL CITRATE INDUCED RETINAL TOXICITY-ELECTRORETINOGRAM, OPTICAL COHERENCE TOMOGRAPHY, AND ADAPTIVE OPTICS FINDINGS. Retin Cases Brief Rep. 2018;12 Suppl 1:S33-S40.
Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.
