Nicotine Replacement Therapy Associated with Persistence of Subretinal Fluid in a Case of Choroidal Neovascularization

We present a patient with central serous chorioretinopathy (CSCR) associated choroidal neovascularization (CNV), who received multiple ranibizumab injections. The patient showed initial improvement with the therapy after which there was an increase in macular thickness. On reviewing his systemic history it was noted that he had been recently put on nicotine replacement therapy (NRT). On stopping the NRT the serous retinal detachment resolved and vision improved. NRT causing nonresolution of CSCR, to our knowledge, has not been described previously. Although there was no definitive proof it was strongly suspected to be the causative factor. Physicians advising NRT with Nicotine Polacrilex chewing gum should be aware of its possible ocular side effects.