Severe retinopathy of prematurity (ROP) in a premature baby treated with sildenafil acetate (Viagra) for pulmonary hypertension

Sildenafil is used as a selective pulmonary vasodilator in children with primary pulmonary hypertension and severe lung fibrosis.1 It improves gas exchange, increasing life expectancy and exercise tolerance. Recent animal models of neonatal pulmonary hypertension have also shown that sildenafil reduces vascular resistance. This has encouraged its use in units treating premature infants.2 We report a case of severe retinopathy of prematurity in a preterm infant who was treated with intravenous sildenafil for severe respiratory failure. The patient was born at 26 weeks gestation weighing 525 g. He was ventilated from birth for respiratory insufficiency, secondary to respiratory distress syndrome. He required high flow oxygen ventilation and received surfactant at delivery and 16 hours later. His oxygen requirements then stabilised at 30–50%. At 29 weeks …