Erectile Dysfunction in Patients with Retinitis Pigmentosa

Erectile dysfunction is a problem familiar to many men and it can worsen with age. Happily, there are a number of ED drugs that help to enhance sexual performance and obtain an erection. Most of the ED drugs, such as Viagra (sildenafil citrate), Cialis (tadalafil), Levitra (vardenafil) and others are selective phosphodiesterase type 5 (PDE5) inhibitors that work to relax the smooth muscles of the vessels in the genital area and improve blood circulation, which leads to easier engorging of the cavernous body and helps to get an erection.

Among the side effects of ED drugs, visual impairment is the most hotly-debated. There are a few types of vision problems associated with PDE5 inhibitors; some of them are temporary, whilst others only supposed to be caused by ED drug. But the most serious issue that could be related to ED treatment is retinitis pigmentosa.

What is Retinitis Pigmentosa?


Retinitis Pigmentosa Causes and Symptoms

This eye is the most common hereditary retinal dystrophy. It does not depend on age and could start at any time of your life and be followed gradual deterioration of vision. The pattern of the disease is individual with more than 50 genetic defects identified that can be revealed in different stages with numerous signs and symptoms.

The most common symptoms of retinitis pigmentosa are following:

  • Difficulties seeing in the night;
  • Reducing peripheral vision (tunnel vision);
  • Increased light sensitivity (photophobia);
  • Difficulties with dark-light adaptation;
  • Problems when evaluating deepness and different levels (like steps or recessions).

All of these symptoms are unspecific and can be present also with other eye diseases. To diagnose retinitis pigmentosa, the fundus examination is required.

You have retinitis pigmentosa with high probability if the following triad is present:

  1. Mottled retinal pigment epithelium (RPE)
  2. The optic nerve appears waxy
  3. Diminution of retinal blood vessels

Retinitis Pigmentosa Treatment

Currently, there is no any treatment for retinitis pigmentosa. This disease is still insufficiently explored. The only retinitis pigmentosa treatment available now is prevention that means to avoid possible risk factors and reduce exposing to irritants, e.g. glares or smoke.

There are some encouraging studies in the field of diet and supplements recommended for renitis pigmentosa treatment and prevention. Thus, the latest researches show that daily intake of some vitamins and antioxidants, especially, retinyl palmitate, can slow down the degeneration of rod photoreceptors. It is not, actually, but a delay of vision deterioration.

Among the others preventing and vision preserving measures are:

  • Using protective sunglasses against bright light,
  • Restrain from smoking and exposing to smoke and pollutions.

Although there is no clear evidence that intake of PDH5 inhibitors can cause vision impairment in those who suffer retinitis pigmentosa, it is believed they can be the risk factor for people who have this disease or other kinds of retinal dystrophy. This supposition is based on the fact that selective PDH5 inhibitors also have an effect on phosphodiesterase type 6 (PDE6) that contain in the retina and responsible for phototransduction. About 3% of men who took Viagra in pre-marketing trials had temporary changes in their vision, but with increased dose that number raised accordingly. Almost all of the participants who took 200 mg doses had side effects, such as blurred vision or changes in color perceptions that passed in a period from 2-3 hours to 1-2 days depending on individual features of the participant.

ED Treatment in Retinitis Pigmentosa

Taking into consideration the above mentioned specific of PDE5 inhibitors, the people with retinitis pigmentosa are strictly advised to consult with a doctor before taking any ED drugs. Those patients who already have a disease may be illegible for ED treatment with medicines of that type.

Another matter is being discussed, whether PED5 inhibitors can contribute to developing of retinitis pigmentosa in patients who regularly takes ED drugs, such as Viagra or Cialis. There are no any clinical data about taking ED drug in these particular groups of people, as well as any filed cases proved that Viagra or any other drug from erectile dysfunction caused retinitis pigmentosa.

Probably, one of the few researches in this field was a study undertaken in the University of New South Wales, Australia on mice. The researchers claimed that sildenafil, which is an active ingredient of Viagra, can cause vision problems to those who have a gene of retinitis pigmentosa. While mice without that gene did not have significant vision problems after receiving a high dose of sildenafil, the mice that carried genes of the disease experienced vision impairment at least for two weeks. Here is important that in a higher risk not only people who already have retinal dystrophy, but also those who only carry the inherited gene. According to the statistics there is 1 in 5000 people who has this gene.

On the other hand, there were no valid researches in people and we could not know exactly how actually PED5 inhibitors affect the retina. The only recommendation for ED patients with retinitis pigmentosa patients or with a gene of hereditary disease is to do treatment with caution. If you suspect you are a carrier of the inherited gene of retinitis pigmentosa, you should talk to your genetic counselor and have regular checkups with an ophthalmologist.

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