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May 2, 2019

Evolution of Ellipsoid Zone Abnormalities on Optical Coherence Tomography Associated With Niacin Maculopathy

Author Affiliations
  • 1Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Ophthalmol. 2019;137(7):849-851. doi:10.1001/jamaophthalmol.2019.0925

Niacin maculopathy is classically characterized by cystoid macular edema (CME) without leakage on fluorescein angiography that resolves on optical coherence tomography (OCT) within weeks to months after dose reduction1 or discontinuation2-6 of niacin, with accompanying resolution or considerable improvement of visual symptoms1-6 and often a return of visual acuity to 20/20 OU.1-3,6 We report a case of niacin maculopathy with ellipsoid zone disruptions on spectral-domain OCT (SD-OCT) that continued to evolve months after niacin discontinuation and resolution of CME, suggesting the possibility of persistent sequelae from niacin toxicity for at least several months after drug discontinuation.