Nicotinic acid treatment for retinal vein occlusion

ABSTRACT

To evaluate the effect of nicotinic acid in management of retinal vein occlusions [CRVO or BRVO]. 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. 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. 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.