Improvement in Near Vision Following Silodosin Treatment in Patients With Lower Urinary Tract Symptoms
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Hyun Jin SHIN
			        		
			        		
			        		
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			        		Woo Suk CHOI
			        		
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			        		Shin-Hyo LEE
			        		
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			        		Andrew G. LEE
			        		
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			        		Aram KIM
			        		
			        		;
		        		
		        		
		        		
			        		Hyoung Keun PARK
			        		
			        		;
		        		
		        		
		        		
			        		Sung Hyun PAICK
			        		
			        		;
		        		
		        		
		        		
			        		Hyeong Gon KIM
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Original Article
 - From:International Neurourology Journal 2021;25(2):164-171
 - CountryRepublic of Korea
 - Language:English
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		        	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. 
            