Tadalafil
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Tadalafil Subretinal and choroidal haemorrhage: case report A 63-year-old man developed subretinal and choroidal haemorrhage during treatment with tadalafil for erectile dysfunction. The man, whose concomitant medication included aspirin, received a single tadalafil 200mg tablet and was awoken a few hours later by severe pain in his left eye. He returned to sleep, but in the morning he had limited left eye sight. Examination showed a noticeably red eye and he was diagnosed with noninfectious conjunctivitis. The man received topical ketorolac eyedrops. One week later, the redness had subsided, but there was no vision improvement and he sought additional evaluation. His left eye vision was counting fingers; early nuclear sclerosis and a shallow anterior chamber were observed. A malignant choroid melanoma was seen. The melanoma was the shape of a fried egg, and had an elevated central part filled with dark blood beneath the retina; there were also haemorrhages in the tumour itself. A fried egg-shaped choroidal tumour was identified by B-scan ultrasound, and an A-scan showed medium to low reflectivity. He was diagnosed with choroidal melanoma with recent haemorrhage. He underwent enucleation of the tumour. Pathological investigation showed a thick and vascularised Bruch membrane, and subretinal pigment epithelial haemorrhage as well as tumour haemorrhage. Marked vascular congestion in the tumour was also seen. [Patient outcome not stated]. Author comment: "We believe that the painful red eye, subretinal and intratumoral hemorrhage, and intratumoral vascular congestion seen in this patient may have been related to the vasodilatory effect of tadalafil in a patient who was also taking aspirin." Abramson DH, et al. Tadalafil-induced subretinal and choroidal hemorrhage in a patient with an unsuspected uveal (choroidal and ciliary body) melanoma. Archives 801044509 of Ophthalmology 124: 1058-1060, No. 7, Jul 2006 - USA
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Reactions 30 Sep 2006 No. 1121
