Long-Term Maintenance of Vision and Resolution of Vitelliform Lesions with Systemic Phosphodiesterase 5/6 Treatment (Sildenafil)

BACKGROUND: Adult vitelliform macular dystrophy results in loss of central vision. The use systemic sildenafil has been proven to increase choroidal blood flow. This is a report favorable long-term treatment outcome using for patient with adult onset dystrophy. CASE PRESENTATION: A 55-year-old woman presenting bilateral subretinal lesions was initially assessed by full-field electroretinogram, electro-oculogram and direct sequencing the RDS/PRPH2 BEST1 genes. Best-corrected visual acuity, spectral domain-optical coherence tomography color fundus photography were obtained analyzed over 5-year course which included bevacizumab (Avastin) injections right eye left subsequent ranibizumab (Lucentis) treatments eye. Lipid resolution seen after two months treatment, while unresponsive eight bevacizumab, followed period twenty months. Systemic started, off label, at 20 following intravitreal injections. Following initiation sildenafil, there both measured patient-reported improvements sildenafil. CONCLUSIONS: phosphodiesterase (PDE)-5 -6 inhibitors may facilitate removal lipid waste from space increasing perfusion patients aid maintaining and/or recovering photoreceptor function.