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

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.