Purpose: We describe the features of niacin maculopathy in a 61-year old man using ocular coherence tomography (OCT), fluorescein angiography, and electroretinography (ERG). Methods: A case report is presented. Results: A 61-year-old male presented with decreased visual acuity. Cirrus OCT revealed bilateral cystic macular edema, without leakage on fluorescein angiography. Dark-adapted maximal-flash ERG demonstrated an absent b-wave. Light-adapted flicker responses revealed diminished amplitude and delayed implicit time (IT). Multifocal ERG demonstrated diffusely decreased amplitudes. Two months after discontinuation of niacin, OCT demonstrated complete resolution of the macular edema. Dark-adapted maximal-flash ERG showed improvement in the b-wave. Light-adapted flicker responses improved in amplitude and decreased IT. Conclusions: To the best of the authors’ knowledge, this case is the first to demonstrate a reduced b-wave in niacin maculopathy. Discontinuation of niacin led to an improved b-wave response suggesting that niacin maculopathy is caused by niacin induced muller cell dysfunction.
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