Sildenafil Use Linked to Higher Risk of Serous Retinal Detachment: Study
USA: Researchers have discovered in a new study that men with erectile dysfunction who used sildenafil were found to have a higher risk of developing serous retinal detachment compared with those who did not use the medication, according to a recent study.
The findings were reported in a brief communication published in the Eye journal by Jaffer Shah from the Department of Ophthalmology at Weill Cornell Medicine, New York, and colleagues. The researchers examined whether sildenafil use is associated with ocular complications in men diagnosed with erectile dysfunction.
Phosphodiesterase type 5 inhibitors, including sildenafil, are widely prescribed for erectile dysfunction. However, previous reports have suggested possible links between these medications and certain eye-related adverse events, such as serous retinal detachment, retinal vascular occlusion, and ischemic optic neuropathy. Large real-world studies specifically evaluating sildenafil have been limited, prompting the researchers to investigate this association using a large clinical dataset.
The team conducted a retrospective cohort study using the TriNetX US Collaborative Network, a large database of de-identified electronic health records from more than 70 healthcare systems in the United States. The study included men aged 18 years or older with a diagnosis of erectile dysfunction. Patients with prior ocular disease, a history of the studied retinal conditions, or exposure to other phosphodiesterase type 5 inhibitors were excluded.
Using propensity score matching, the researchers created two comparable groups: men with erectile dysfunction who had documented sildenafil use and those without recorded exposure to the medication. Each cohort included 208,930 patients, with mean ages of 56.9 years in the sildenafil group and 56.6 years in the non-user group.
The primary outcome assessed was the development of serous retinal detachment within one year. Secondary outcomes included retinal vascular occlusion and ischemic optic neuropathy.
The researchers reported the following findings:
- Sildenafil users had a 54% higher risk of developing serous retinal detachment compared with non-users.
- Despite the increased relative risk, the absolute incidence remained low, occurring in 0.04% of sildenafil users and 0.02% of non-users within one year.
- The study did not find a significant association between sildenafil use and retinal vascular occlusion.
- No significant link was observed between sildenafil use and ischemic optic neuropathy.
- The findings suggest that the ocular effects of sildenafil may be more specific to serous retinal detachment rather than ischemic complications affecting retinal blood vessels or the optic nerve.
The authors noted that phosphodiesterase type 5 inhibition may influence choroidal blood flow and vascular permeability, which could potentially contribute to fluid accumulation beneath the retina and explain the observed association.
Overall, the findings add to previous evidence suggesting a possible relationship between sildenafil use and serous retinal detachment in men with erectile dysfunction. However, the researchers emphasized that the absolute risk remains low and further studies are needed to better understand the underlying biological mechanisms and clinical implications.
Reference:
Shah, J., Serhan, H., Festok, M., Ahmed, H., Solli, E., Mahrous, M. A., Kovacs, K. D., & Kiss, S. (2026). Sildenafil use and risk of serous retinal detachment in men with erectile dysfunction in US. Eye, 1-2. https://doi.org/10.1038/s41433-026-04326-2
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