Regular use of phosphodiesterase type 5 inhibitors (PDE5Is) for erectile dysfunction was associated with increased risks of serous retinal detachment (SRD), retinal vascular occlusion (RVO), and ischemic optic neuropathy (ION) among older US men in a large observational study. PDE5Is are among the most prescribed medication classes in the US and include avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

The study included 213 033 men in a medical claims database who had at least 1 PDE5I prescription every 3 months in the prior year. A nested case-control analysis included 1146 adverse event cases and a control group of 4584 age-matched patients. The average age in both groups was about 65 years but patients who experienced the adverse events were more likely to have hypertension, diabetes, coronary artery disease, and sleep apnea.