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Effect of oral niacin on central retinal vein occlusion

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Niacin, a treatment for dyslipidemia, is known to induce vasodilation as a secondary effect. Previous instances of patients with chronic central retinal vein occlusion (CRVO) and cystoid macular edema (CME) have been observed to spontaneously improve when placed on systemic niacin for hypercholesterolemia. The purpose of this study was to evaluate the effects of niacin on CRVO and associated ocular complications.

Methods

A prospective, single-center, non-randomized, interventional case series of niacin for CRVO was conducted. Best-correct visual acuity (BCVA), central macular thickness (CMT), and ocular complications were analyzed in 50 patients over 1 year. Eight patients were controls.

Results

The mean initial logMAR BCVA was 0.915, and improved with niacin to 0.745 (P = 0.12), 0.665 (P = 0.02) and 0.658 (P = 0.03) after 3, 6, and 12 months of follow-up, respectively. At baseline, mean CMT was 678.9 μm, and improved to 478.1 μm (P = 0.001), 388.6 μm (P < 0.001), and 317.4 μm (P < 0.001) for the same time points. The control group had a mean initial logMAR BCVA of 1.023, which gradually deteriorated to 1.162 (P = 0.36) after 12 months, and baseline CMT of 700.0 μm at baseline, which gradually improved to 490.9 μm (P = 0.06) after 12 months. Panretinal photocoagulation for neovascularization was required in 5 patients (13.2%) receiving niacin and 3 (37.5%) controls.

Conclusions

These data suggest that niacin may be associated with functional and anatomic improvements in eyes with CRVO. Future investigations will help ascertain whether there is a role for niacin as an adjunct therapy to intravitreal injections in the management of CRVO.

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Acknowledgements

The authors would like to thank Juliana Tolles, MD (Stanford University, Palo Alto, CA, USA) for her assistance with the statistical analysis.

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Authors and Affiliations

  1. Department of Ophthalmology, Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA, 94301, USA

    Michael W. Gaynon & Ehsan Rahimy

  2. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA

    Yannis M. Paulus

  3. Byers Eye Institute, Stanford University, Stanford, CA, USA

    Yannis M. Paulus

  4. Department of Ophthalmology, George Washington University, Washington, DC, USA

    Janet L. Alexander & Sam E. Mansour

  5. Department of Ophthalmology, University of Maryland, Baltimore, MD, USA

    Janet L. Alexander

  6. Virginia Retina Center, Warrenton, VA, USA

    Sam E. Mansour

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  1. Michael W. Gaynon
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  4. Janet L. Alexander
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Corresponding author

Correspondence to Ehsan Rahimy.

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Financial disclosures

The authors have no relevant financial disclosures.

Funding

The Heed Ophthalmic Foundation provided financial support (Paulus) in the form of fellowship grant funding. The sponsor had no role in the design or conduct of this research.

Conflict of Interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gaynon, M.W., Paulus, Y.M., Rahimy, E. et al. Effect of oral niacin on central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 255, 1085–1092 (2017). https://doi.org/10.1007/s00417-017-3606-0

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  • DOI: https://doi.org/10.1007/s00417-017-3606-0

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