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The final step of BH 4 synthesis actually involves three distinct steps all of which are catalyzed by the NADPH-dependent enzyme, sepiapterin reductase (SR)

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Proc Natl Acad Sci USA 1993

Additionally, given the results found by Galvez-Ruiz et al 13 which suggest a potential association between phosphodiesterase-5 (PDE5) inhibitor use and increased risk of NAION, we excluded patients with documented PDE5 inhibitor prescriptions to minimize confounding

Nanoscale materials possess distinct risk profiles owing to their small size, enhanced biological reactivity, and unique physicochemical properties

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