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. 2013 Aug 20:1:2050312113495195.
doi: 10.1177/2050312113495195. eCollection 2013.

Sildenafil dilates ophthalmic artery in type 2 diabetic patients

Akeel Amh Zwain  1 , Najah R Hadi  2 , Ahmed M Al-Mudhaffer  3
Affiliations

Sildenafil dilates ophthalmic artery in type 2 diabetic patients

Akeel Amh Zwain et al. SAGE Open Med. .

Abstract

Background: Conflicting reports exist on the effect of sildenafil on ophthalmic artery blood flow; many visual disturbances due to vascular insult were reported with the use of sildenafil in diabetic patients like nonarteritic ischemic optic neuropathy.

Objectives: The present work aimed to investigate whether sildenafil modulates ophthalmic artery vasoreactivity in patients with type 2 diabetes mellitus. Literature reports on this aspect are lacking.

Methods: A total of 35 male subjects were enrolled in this study, 18 with type 2 diabetes mellitus matched with 17 normal individuals. Ophthalmic artery was insonated through a transorbital window using colored Doppler equipment with transcranial Doppler facility. Ophthalmic artery reactivity was assessed using breath holding/hyperventilation test, before and after giving 50 mg oral sildenafil.

Results: It was found that in both normal subjects and diabetic patients, sildenafil increased baseline control of mean flow velocity of ophthalmic artery significantly (p < 0.05), breath holding caused a decrease of MFVopa (p < 0.05), and subsequent hyperventilation caused increase of MFVopa (p < 0.05). There was no statistically significant change in breath holding index and full range of vasodilatation of ophthalmic artery (p > 0.05) after sildenafil, in normal and diabetic groups. There was a significant increase of resistive index of ophthalmic artery flow in diabetic patients compared with that of normal subject (p < 0.05). Sildenafil decreased resistive index of ophthalmic artery flow significantly only in diabetic patients (p < 0.05).

Conclusion: Sildenafil increased MFVopa, but had no significant effect on vasoreactivity of ophthalmic artery; sildenafil decreased resistive index only in type 2 diabetic patients.

Keywords: Sildenafil; ophthalmic artery; transcranial Doppler; vasoreactivity.

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Conflict of interest statement

Declaration of conflicting interests: The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Effect of sildenafil on MFV of OPA in normal and diabetic groups. MFV: mean flow velocity; OPA: ophthalmic artery; C: control, DM: diabetes mellitus, BH: breath holding, HV: hyperventilation.
Figure 2.
Figure 2.
Doppler spectral wave form images of the OPA of diabetic patient showing the effect of giving sildenafil on OPA flow velocity during breath holding and subsequent hyperventilation. Top panel: (a) baseline control, (b) breath holding and (c) hyperventilation, before giving sildenafil. Bottom panel: after giving sildenafil (d) baseline control, (e) breath holding, and (f) hyperventilation. An increase of PSV and EDV with decrease of RI after giving sildenafil was evident. OPA: ophthalmic artery; PSV: peak systolic velocity; EDV: end diastolic velocity; RI: resistive index.
Figure 3.
Figure 3.
Doppler spectral wave form images of the ophthalmic artery of healthy subject showing increased PSV and EDV, after sildenafil. (a) Baseline recording, (b) after giving sildenafil, (c) breath holding before sildenafil, (d) breath holding after sildenafil, (e) hyperventilation before sildenafil, and (f) hyperventilation after sildenafil. PSV: peak systolic velocity; EDV: end diastolic velocity.
Figure 4.
Figure 4.
Effect of sildenafil on BHI of OPA in normal and diabetic persons. BHI: breath holding index; OPA: ophthalmic artery; DM: diabetes mellitus.
Figure 5.
Figure 5.
Effect of sildenafil on FVD of OPA in normal and diabetic persons. OPA: ophthalmic artery; FVD: full range of vasodilatation; DM: diabetes mellitus.
Figure 6.
Figure 6.
Effect of sildenafil on RI of OPA in normal and diabetic persons. OPA: ophthalmic artery; RI: resistive index; C: control; DM: diabetes mellitus; BH: breath holding; HV: hyperventilation.
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