Ocular Effects of Niacin: A Review of the Literature

Abstract

Cystoid macular edema is a condition that involves the macula, caused by an accumulation of extracellular fluid in the macular region with secondary formation of multiple cystic spaces. This condition is provoked by a variety of pathological conditions such as intraocular inflammation, central or branch retinal vein occlusion, diabetic retinopathy and most commonly following cataract extraction, hereditary retinal dystrophies, and topical or systemic assumption of drugs. Niacin is a vitamin preparation usually used for the treatment of lipid disorders. The treatment with niacin, alone or in combination with other lipid-lowering agents, significantly reduces total mortality and coronary events and slows down the progression of and induces the regression of coronary atherosclerosis. Several cases of niacin-induced cystoid macular edema have been reported with different dosages.

Keywords: Cystoid Macular Edema; Niacin Maculopathy; Nicotinic Acid; Side Effects.

Figure 1

On the left, there is an image of Stratus OCT 2 weeks after the start of niacin treatment. On the right fluorescein angiography of the same patient after 3 weeks after the beginning of niacin treatment with the typical absence of leakage also in later phases