ArticleEye (London, England)2026
Phosphodiesterase 5 inhibitor use and incident diabetic retinopathy in men with erectile dysfunction and type 2 diabetes: a propensity-matched cohort study.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
BACKGROUND/
objectivesTo evaluate the association between phosphodiesterase type 5 inhibitor (PDE5I) use and incident diabetic retinopathy (DR) among men with erectile dysfunction (ED) and type 2 diabetes (T2D). SUBJECTS/
methodsMale patients aged ≥50 years with ED and T2D were identified from the TriNetX global electronic health record network. Patients receiving PDE5I were compared with non-users. After 1:1 propensity score matching for demographic, systemic, laboratory and treatment-related variables, 1823 patients were included in each cohort. Follow-up extended for up to seven years. Outcomes were identified using ICD-10 and procedural codes and analysed using Kaplan-Meier survival analysis and Cox proportional hazards models. Ophthalmologic follow-up was evaluated as a negative-control outcome to assess surveillance bias.
resultsDuring follow-up, PDE5I use was associated with a lower incidence of DR overall (hazard ratio [HR] 0.83, 95% confidence interval [CI] [0.71, 0.96]; p = 0.0139; adjusted p = 0.0626) and proliferative diabetic retinopathy (PDR; HR 0.35, 95% CI [0.21, 0.59]; p < 0.0001; adjusted p < 0.0009). After correction for multiple comparisons, only the association with PDR remained statistically significant (adjusted p < 0.0009). No significant differences were observed for diabetic macular oedema, intravitreal injections, or laser photocoagulation. Rates of ophthalmologic follow-up were comparable between groups (HR 0.93, 95% CI [0.84, 1.02]; p = 0.1072).
conclusionsIn men aged ≥50 years with ED and T2D, PDE5I use was associated with a lower observed incidence of PDR, while a nominal association with overall DR was also observed. These findings identify an association between PDE5I use and DR outcomes that warrants further evaluation in prospective studies.
Identifiers
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Registered trials
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