Diffuse macular edema in niacin-induced maculopathy may resolve with dosage decrease

Retin Cases Brief Rep. Summer 2011;5(3):227-8. doi: 10.1097/ICB.0b013e3181e180c0.


Purpose: To report on a patient with niacin-induced cystic maculopathy that resolved with dosage decrease, not discontinuation, of niacin therapy for dyslipidemia.

Methods: Retrospective case report. The patient was being followed for vision changes, but his niacin therapy was managed elsewhere.

Results: Results of the decrease in niacin dosage show clear evidence (with optical coherence tomography) of resolution of retinal edema.

Conclusion: Our conclusion is that niacin's toxicity has a threshold, and dosage decrease below this threshold allows continuation of therapy at the lower dosage without clinically evident adverse effects on the retina.