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

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.