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. 2013:2013:713061.
doi: 10.1155/2013/713061. Epub 2013 Apr 11.

Cystoid macular edema induced by low doses of nicotinic Acid

Daniela Domanico  1 , Carmela Carnevale, Serena Fragiotta, Francesca Verboschi, Simona Altimari, Enzo Maria Vingolo
Affiliations

Cystoid macular edema induced by low doses of nicotinic Acid

Daniela Domanico et al. Case Rep Ophthalmol Med. 2013.

Abstract

Cystoid macular edema (CME) is a condition that involves the macula, causing painless vision loss. In this paper, we report a case of niacin-induced bilateral cystoid macular edema (CME) in a middle-age woman taking low dose of niacin (18 mg of nicotinic acid). Optical coherence tomography (OCT) showed retinal thickening and cystoid spaces in both eyes, whereas fluorescein angiography (FA; HRA 2, Heidelberg Engineering) revealed the absence of fluorescein leakage also in later phases. Four weeks after discontinuation of therapy there were a complete disappearance of macular edema at funduscopic examination and an improvement of visual acuity in both eyes. Furthermore OCT showed a normal retinal profile in both eyes. In our opinion considering the wide availability of niacin, medical monitoring and periodical examination should be considered during niacin administration. To our knowledge, this is the first report in the literature that described the very low-dose niacin-induced bilateral niacin maculopathy.

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Figures

Figure 1
Figure 1
(a) Stratus OCT during niacin treatment. Abnormal retinal profile with the presence of hyporeflective cystoid spaces in the outer plexiform and inner nuclear layers in both eyes. Central macular thickness (CMT) was 646 microns in RE and 578 microns in LE. (b) Stratus OCT four weeks after discontinuation of therapy. Normal retinal thickness with complete disappearance of the hyporeflective cystoid spaces. Central macular thickness (CMT) was 195 microns in RE and 194 microns in LE.
Figure 2
Figure 2
Fluorescein angiography of the right (a) and left (b) eyes nine minutes after injection of fluorescein that revealed the absence of fluorescein leakage typical of cystoid macular edema induced by nicotinic acid in both eyes.
See this image and copyright information in PMC

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