Nicotinic Acid Treatment for Retinal Vein Occlusion

Objectives: To evaluate the effect of nicotinic acid in management of retinal vein occlusions (CRVO or BRVO). Materials and Methods: This prospective nonrandomized pilot study included 20 patients (21 eyes) with CRVO or BRVO that received nicotinic acid (3 g/day) for 3 months. A complete ophthalmologic examination uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), testing for a relative afferent pupillary defect (RAPD), slit-lamp examination, gonioscopy, intraocular pressure (IOP) measurement, fundoscopy and fundus photography was performed. Results: Four patients did not appear for follow-up and hypersensitivity reaction to nicotinic acid and severe hyperglycemia happened in two patients. Therefore, the results of treatment in 16 eyes of 15 are reported. These patients had a mean age of 59.56 ± 11.12 years. The average length of follow-up was 8.6 ± 2.7 months. The mean BSCVA was 1.56 ± 0.66 before treatment, 1.38 ± 0.72 (p > 0.05) at one month and 0.88 ± 0.69 (p<0.01) at three months. The last BSCVA of all 16 eyes averaged 0.97 ± 0.73 (p<0.01). All patients had reduction of hemorrhagic events, cotton wool spots, edema in macula and disc, venous tortuosity, and dilation on basis of fundus photographs 3 months after treatment. Conclusion: Nicotinic acid usage provides enough time for development of collateral vessels, by induction of vasodilatation. Nicotinic acid use is tolerable and is related with mild systemic side effects.  

Keywords:

BRVO , CRVO , Niacin , Nicotinic acid , retinal vein occlusion