“万艾可”相关性黄斑浆液性脱离

Viagra-associated serous macular detachment

Purpose: To describe the OCT findings in two cases of idiopathic serous macula r detachments associated with Sildenafil (Viagra) use. Methods: Two patients wer e identified with idiopathic serous macular detachments associated with Viagra u se. Each patient underwent rigorous historical questioning to rule out known cau ses of serous macular detachments and to determine contributing factors. A compr ehensive ocular examination was performed including dilated biomicroscopic exami nation of the macula and indirect ophthalmoscopic evaluation of the retinal peri phery. Additional evaluation included color fundus photography with FA and ICG,O CT analysis of the macula and B-scan ultrasonography. Systemicworkup included M RI of the brain and orbits, CT of the brain, orbits, chest and abdomen, blood ch emistries and electrophoresis, lumbar puncture with CSF analysis and chest radio graphs. Results: Both patients demonstrated idiopathic serous macular detachment associated with peri-macular vitelliform deposits. Although notable peripapill ary atrophy and RPE mottling were present, there was no evidence of heme, exudat e, or fibrosis to suggest a CNVM. FA showed no focal areas of leakage. Early and late frames of the ICG demonstrated engorged choroidal vessels without frank le akage. Extensive medical evaluation failed to reveal a systemic etiology. OCT fi ndings demonstrated large serous macular detachments that corresponded to the us e or discontinuation of Viagra. Discontinuation of Viagra coincided with complet e resolution of the serous macular detachment in one patient and improvement of the serous macular detachment in the other. When one patient resumed Viagra use, he experienced a recurrent serous macular detachment. Conclusions: We report th e OCT findings of two cases of idiopathic serous macular detachment associated w ith use of the potent vasodilator Sildenafil (Viagra).