Int Neurourol J.  2021 Jun;25(2):164-171. 10.5213/inj.2040274.137.

Improvement in Near Vision Following Silodosin Treatment in Patients With Lower Urinary Tract Symptoms

Affiliations
  • 1Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  • 2Department of Urology, Konkuk University School of Medicine, Seoul, Korea
  • 3Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
  • 5Department of Ophthalmology, Neurology, Neurosurgery, Weill Cornell Medicine, New York, NY, USA
  • 6Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
  • 7Department of Ophthalmology, UT MD Anderson Cancer Center, Houston, TX, USA
  • 8Department of Ophthalmology, Texas A and M College of Medicine, College Station, TX, USA
  • 9Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
  • 10Department of Ophthalmology, Baylor College of Medicine and the Center for Space Medicine, Houston, TX, USA
  • 11Department of Ophthalmology, University of Buffalo, Buffalo, NY, USA

Abstract

Purpose
The objective of this study was to investigate the change in near visual function after the administration of oral silodosin to patients with lower urinary tract symptoms (LUTS).
Methods
This prospective study included treatment-naive patients who were scheduled to start treatment with silodosin for LUTS. A comprehensive ophthalmological evaluation including the near vision and the automated pupillometry was performed at baseline and after 3 months of silodosin treatment. For subjective assessment of near visual ability and satisfaction, a Near Activity Visual Questionnaire-10 (NAVQ-10) was also used at the same time (higher scores indicating worse quality).
Results
Of 23 patients enrolled in this study, 15 continued with silodosin (8 mg once daily) treatment for 3 months and completed a follow-up evaluation. The mean age of participants was 60.4±8.4 years. Distant visual acuity and spherical error were unchanged after silodosin treatment. However, near vision acuity (logMAR) was improved after treatment (right, 0.47±0.36 vs. 0.38±0.39, P=0.018; left, 0.41±0.37 vs. 0.31±0.34, P=0.068; both, 0.27±0.26 vs. 0.21±0.27, P=0.043). Pupil size under room light decreased significantly in both eyes (right, 3.77±0.60 vs. 3.16±0.58, P=0.001; left, 3.72±0.80 vs. 3.21±0.75, P=0.002). The Rasch scale at NAVQ-10 improved from 54.7±9.9 to 48.5±11.2 (P=0.004).
Conclusions
This preliminary study demonstrated that highly selective alpha-1A adrenergic receptor antagonists such as silodosin improve near visual acuity and quality in patients with LUTS/benign prostatic hyperplasia. Decrease in pupil size caused by inhibition of adrenergic alpha 1 mediated contraction of iris dilator muscle is a possible mechanism underlying improved near vision.

Keyword

Silodosin; Receptors, adrenergic, alpha-1; Myopia; Presbyopia; Pupil
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