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Effects of Sildenafil on Choroidal Thickness in AMD

This study has been terminated.
(Inadequate support to complete recruitment/data analysis.)
Information provided by (Responsible Party):
Duke University Identifier:
First received: April 10, 2013
Last updated: May 27, 2015
Last verified: April 2015
Choroidal thinning has been hypothesized to partake in the pathogenesis of age-related macular degeneration (AMD), but it is not known if increasing choroidal thickness may potentially alter the disease course. Past studies have shown that a single dose of the phosphodiesterase type-5 inhibitor sildenafil citrate can increase choroidal thickness in young healthy patients. The investigators hypothesize that sildenafil may also increase choroidal thickness in eyes with AMD and perhaps potentially reduce AMD progression. Alternatively, if sildenafil has minimal effect on choroidal thickness in eyes in patients with AMD, such results may suggest that choroidal vascular compliance or stiffness is reduced in this condition. Patients seen at the Duke Eye Center with a diagnosis of AMD or age-matched control subjects with no macular pathology will be administered a single 100mg oral dose of sildenafil citrate (Viagra®; Pfizer), and undergo EDI-OCT imaging before and after treatment. Images obtained will be used to measure choroidal thickness, as well as central macular thickness (CMT) and macular volume (MV). Choroidal thickness changes after a single-dose sildenafil treatment in AMD patients will be compared with age-matched control subjects using standard statistical methods. By also correlating choroidal thickness changes with functional (visual acuity) and anatomical (CMT & MV) changes, the investigators hope to further their understanding of the choroid's role in aging and AMD pathogenesis. The safety of a single dose of sildenafil citrate will be addressed by excluding any patients with risk factors or using medications that are contraindicated for sildenafil as determined by careful informed consent and a study questionnaire.

Condition Intervention Phase
Age-related Macular Degeneration Drug: Sildenafil citrate Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Effects of Sildenafil on Choroidal Thickness in Age-Related Macular Degeneration

Resource links provided by NLM:

Further study details as provided by Duke University:

Primary Outcome Measures:
  • Change in Choroidal Thickness as Assessed on Enhanced-Depth Imaging Optical Coherence Tomography (EDI-OCT) [ Time Frame: Baseline, 1 hour, and 3 hours post-treatment ]

Secondary Outcome Measures:
  • Change in Central Foveal Thickness as Assessed by Optical Coherence Tomography (OCT) [ Time Frame: Baseline, 1hour, and 3 hours post-treatment ]

Enrollment: 10
Study Start Date: March 2013
Study Completion Date: May 2014
Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Healthy Controls
Healthy individuals >65 years old without ocular disease, who will be given a single dose of 100mg sildenafil citrate, then imaged with EDI-OCT to determine a change in choroidal thickness
Drug: Sildenafil citrate
Single dose of 100mg Sildenafil citrate
Other Names:
  • Viagra
  • Revatio
Experimental: AMD patients
Age-related macular degeneration (AMD) patients >65 years old without other ocular disease, who will be given a single dose of 100mg sildenafil citrate, then imaged with EDI-OCT to determine a change in choroidal thickness
Drug: Sildenafil citrate
Single dose of 100mg Sildenafil citrate
Other Names:
  • Viagra
  • Revatio


Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • has been diagnosed with AMD (362.50-52) or healthy controls as detailed above
  • at least 65 years of age
  • capable and willing to provide consent

Exclusion Criteria:

  • History of previous photodynamic therapy (PDT), intravitreal corticosteroid injection, macular focal laser photocoagulation, panretinal photocoagulation, ocular ionizing irradiation, transpupillary thermotherapy, or any vitreoretinal surgeries
  • History of central serous chorioretinopathy, polypoidal choroidal vasculopathy, uveitis, or diabetic retinopathy
  • History of amblyopia, glaucoma, retinal detachment, retinal dystrophy, ocular trauma, ocular tumor, proliferative retinopathy, or epiretinal membrane with distortion of central macula
  • History of myopia of more than 6 diopters (D) spherical equivalent
  • History of uncontrolled diabetes or hypertension
  • Current use of oral phosphodiesterase type 5 inhibitors (including sildenafil, avanafil, lodenafil, mirodenafil, tadalafil, vardenafil, udenafil, zaprinast)
  • Current use of systemic corticosteroids
  • Any contraindication to sildenafil use, including history of cardiovascular disease or stroke, hepatic cirrhosis (Child-Pugh A and B), severe renal impairment (creatinine clearance <30mL/min), anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease), disorders predisposing to priapism (e.g. sickle cell anemia, multiple myeloma, or leukemia), or current use of organic nitrates, alpha-blockers, or potent cytochrome P450 3A4 inhibitors
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Please refer to this study by its identifier: NCT01830790

United States, North Carolina
Duke Eye Center
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Principal Investigator: Sharon Fekrat, MD Duke University Eye Center
  More Information

Responsible Party: Duke University Identifier: NCT01830790     History of Changes
Other Study ID Numbers: Pro00042897
Study First Received: April 10, 2013
Results First Received: April 29, 2015
Last Updated: May 27, 2015

Additional relevant MeSH terms:
Macular Degeneration
Retinal Degeneration
Retinal Diseases
Eye Diseases
Sildenafil Citrate
Citric Acid
Vasodilator Agents
Phosphodiesterase 5 Inhibitors
Phosphodiesterase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Urological Agents
Calcium Chelating Agents
Chelating Agents
Sequestering Agents processed this record on June 23, 2017