Cystoid macular edema (CME) is a condition that involves the macula, causing painless vision loss. In this paper, we report a case of niacin-induced bilateral cystoid macular edema (CME) in a middle-age woman taking low dose of niacin (18？mg of nicotinic acid). Optical coherence tomography (OCT) showed retinal thickening and cystoid spaces in both eyes, whereas fluorescein angiography (FA; HRA 2, Heidelberg Engineering) revealed the absence of fluorescein leakage also in later phases. Four weeks after discontinuation of therapy there were a complete disappearance of macular edema at funduscopic examination and an improvement of visual acuity in both eyes. Furthermore OCT showed a normal retinal profile in both eyes. In our opinion considering the wide availability of niacin, medical monitoring and periodical examination should be considered during niacin administration. To our knowledge, this is the first report in the literature that described the very low-dose niacin-induced bilateral niacin maculopathy. 1. Introduction Cystoid macular edema (CME) is a disorder which involves the central retina, caused by an accumulation of extracellular fluid in the macular region with secondary formation of multiple cystic spaces [1]. The edema affects outer plexiform and inner nuclear layers of the retina and is generally related to permeability changes in blood-retinal barrier that limits the intraretinal movements of plasmatic components and maintains a right homeostasis. Various conditions can cause cystoid maculopathy such as retinal vascular diseases, intraocular inflammatory diseases, ocular surgery especially cataract extraction, hereditary retinal dystrophies, and topical or systemic assumption of drugs [2, 3]. In this paper we report the case of a healthy woman that, after a daily assumption of 18？mg of nicotinic acid, has developed a cystoid macular edema in both eyes. 2. Case Presentation A 53-year-old female (P.P.) was admitted to our Department of Ophthalmology, Sapienza University of Rome, Polo Pontino, for a sudden decrease of visual acuity in both eyes, blurred vision, and metamorphopsia. She had a medical history of hypertension and type 2 diabetes mellitus well controlled with oral hypoglycemic agents. In the past she had never presented with any vision trouble, previous history of ophthalmological diseases, or ocular surgery. Plasma cholesterol levels slightly higher than the normal range were incidentally found on a routine blood testing. Therefore her general practitioner prescribed her dietary changes, lifestyle modifications, and oral
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