Phosphodiesterase type 5 inhibitors (PDE5i) are widely used for erectile dysfunction. Case reports and claims-based cohort studies have suggested associations between PDE5i use and ocular adverse events, including serous retinal detachment (SRD), retinal vascular occlusion (RVO), and ischemic optic neuropathy (ION) [1]. However, large multicentre evidence specific to sildenafil in real-world data is limited.
We conducted a retrospective cohort study using the TriNetX US collaborative network, a federated database of de-identified electronic health records from over 129 million patients across over 70 health systems. Men aged ≥18 years with an ICD-10 diagnosis of erectile dysfunction (N52) were included. Exposure was defined as documented of sildenafil use (RxNorm 136411); the control cohort comprised patients with erectile dysfunction and no recorded sildenafil exposure. Patients with a prior history of SRD, RVO, ION, other ocular disease history, or other PDE5i exposure (Tadalafil RxNorm 358263; Avanafil RxNorm 1291301; Vardenafil RxNorm 306674) were excluded from the analyses.