A double-blind placebo-controlled evaluation of the acute effects of sildenafil citrate (VIAGRA) on visual function in subjects with early-stage age-related macular degeneration

PURPOSE: To assess the effects of a single 100-mg dose of sildenafil citrate on visual function in men with early-stage age,related macular degeneration. DESIGN: Randomized double,blind placebo,controlled clinical trial. METHODS: Nine men (mean age 71 years, range 59-85 years) with early-stage (minimal visual impairment and large drusen in the macula) age,related macular degeneration and 20/40 or better-corrected visual acuity in at least one eye were prospectively randomized to receive either placebo or sildenafil citrate (Viagra; Pfizer Inc, New York, New York) 100 mg as a single oral dose. After 7-14 days, they received the alternate treatment. Subjects underwent visual acuity, Amsler grid, color discrimination (D15), traffic light, Humphrey perimetry, and photo,stress testing in each eye before and at specific intervals within 8 hours after dosing. RESULTS: Compared with placebo, no pattern of errors were evident in any visual function test following sildenafil administration. No statistically or clinically relevant changes from baseline were observed in visual acuity, Humphrey perimetry (corrected pattern standard deviation), D 15 color discrimination, or photo-stress tests. No clinically relevant changes were observed in the Amsler grid or traffic light tests. Sildenafil treatment was associated with transient mild or moderate headache, flushing, and rhinitis. There were no visual adverse events spontaneously reported to the investigator. CONCLUSION: A single 100,mg dose of sildenafil was well tolerated and produced no acute visual effects or exacerbation of preexisting visual impairment in nine men with early,stage age related macular degeneration.