Un cas rare de maculopathie cystoïde

We describe the case of a healthy 67-year-old Caucasian female who developed a rare, reversible case of cystoid maculopathy without late leak on fluorescein angiogram. She presented initially with a 5-year history of bilateral, variable central scotomata. The visual acuities were 6/6, while foveal reflexes were abnormal. Fluorescein angiogram showed no leakage; however, optical coherence tomography (OCT) revealed cystic spaces in the fovea of both eyes. The patient had been taking niacin supplements averaging 100 mg daily for 30 years. Niacin was discontinued, and 7 months later, her symptoms and OCT results improved. Although niacin-induced maculopathy is uncommon, the clinician should enquire about possible niacin supplementation in any patient with cystoid macular edema in the absence of late leakage on fluorescein angiography. We describe a new reason for niacin maculopathy due to chronic low dose niacin supplementation and a slower pattern of visual recovery than that previously suggested in the literature.