Glaucoma and erectile dysfunction
Reviewed by Chrysostomos D Dimitriou

In this cross-sectional study with patient questionnaire and retrospective chart review, a total of 167 male patients over 40 years of age were enrolled. Exclusion criteria included previous exposure to radiation and surgical treatment for prostate benign hypertrophy or malignancy. The International Index of Erectile Function questionnaire was utilised to determine the severity of erectile dysfunction. The presence of glaucoma was validated by a previous diagnosis. Using a crude odds ratio, researchers found glaucoma was a significant risk factor for erectile dysfunction in the study subjects, with an odds ratio of 2.58. Current smoking was the only significant covariate in the study population. “Comparison of mean erectile dysfunction (ED) score between cases and controls revealed significantly lower scores (more severe ED) in patients with glaucoma, with a score of 18.3 in the glaucoma group and 22.4 in the control group (P = 0.02),” the study authors concluded. They also found no association between specific medication classes including beta-blockers, prostaglandins, a-agonists, and carbonic anhydrase inhibitors. In a previous relevant study (Ophthalmology 2012) Chung et al. suggested that the vascular dysregulation seen in the metabolic syndrome (hyperglycaemia, systemic hypertension and dyslipidaemia) plays a role in the association found between glaucoma and erectile dysfunction. However, their analysis and also that of Nathoo et al. (J Glaucoma 2013) admitted that this could not be fully explained by these comorbidities. Alternative hypotheses include chronic inflammatory changes occurring in the endothelial vascular wall, resulting in compromised vascular function and blood flow that may contribute to the pathophysiology we see in both conditions.

Correlation in severity between glaucoma and erectile dysfunction.
Law G, Nathoo N, Reiner, et al.
JOURNAL OF GLAUCOMA
2016;25(9):716-9