Hussein Almuhtaseb senior medical retina fellow, Osama Kanavati medical retina fellow, Andrew Lotery professor of ophthalmology
Almuhtaseb H, Kanavati O, Lotery A.
Branch retinal vein occlusion secondary to sildenafil
BMJ 2017; 356 :j753
doi:10.1136/bmj.j753
Re: Branch retinal vein occlusion secondary to sildenafil
The authors nicely described a case of branch retinal vein occlusion and highlighted the importance of detailed medical and other relevant history. These histories help the treating physician not only to make a diagnosis but also warn patients regarding the risk factors of relapse of the diagnosed conditions. I want to add some valid points in this case as well as general things to be followed in case of drugs adverse effects.
Here the authors have correlated BRVO with use of sildanifil in the absence of other medical conditions. It is to be noted that BRVO generally occurs in elderly people as old age itself is a risk factor for its occurrence in the absence of other medical conditions. Also the signs and symptoms pertaining to the adverse effect of drugs will appear within shortest possible duration in response to the medication. Here in this case the history says frequent usage of sildanifil and occurrence of symptoms in variable time period. So the exact timing between drug consumption and occurence of symptoms will help for better correlation. It will be mostly helpful to use WHO causality assessment scale or naranjo scale for such relation between drugs and their adverse effects.
Finally this case adds evidence to the already published reports on retinal vein occlusion because of sildanifil and generally warrants pharmacovigilance regarding the occurrence of branch retinal vein occlusion.
Competing interests: No competing interests