Cited by 106Glaucoma and retinal disordersSirtuins and Resveratrol in MedicineNeurological Disorders and Treatments

Glaucoma as a Metabolic Optic Neuropathy: Making the Case for Nicotinamide Treatment in Glaucoma

Open access
Williams, Pete A., Harder, Jeffrey M., John, Simon W.M.·2017·Journal of Glaucoma

Abstract

Mitochondrial dysfunction may be an important, if not essential, component of human glaucoma. Using transcriptomics followed by molecular and neurobiological techniques, we have recently demonstrated that mitochondrial dysfunction within retinal ganglion cells is an early feature in the DBA/2J mouse model of inherited glaucoma. Guided by these findings, we discovered that the retinal level of nicotinamide adenine dinucleotide (NAD, a key molecule for mitochondrial health) declines in an age-dependent manner. We hypothesized that this decline in NAD renders retinal ganglion cells susceptible to damage during periods of elevated intraocular pressure. To replete NAD levels in this glaucoma, we administered nicotinamide (the amide of vitamin B 3). At the lowest dose tested, nicotinamide robustly protected from glaucoma (~70% of eyes had no detectable glaucomatous neurodegeneration). At this dose, nicotinamide had no influence on intraocular pressure and so its effect was neuroprotective. At the highest dose tested, 93% of eyes had no detectable glaucoma. This represents a ~10-fold decrease in the risk of developing glaucoma. At this dose, intraocular pressure still became elevated but there was a reduction in the degree of elevation showing an additional benefit. Thus, nicotinamide is unexpectedly potent at preventing this glaucoma and is an attractive option for glaucoma therapeutics. Our findings demonstrate the promise for both preventing and treating glaucoma by interventions that bolster metabolism during increasing age and during periods of elevated intraocular pressure. Nicotinamide prevents age-related declines in NAD (a decline that occurs in different genetic contexts and species). NAD precursors are reported to protect from a variety of neurodegenerative conditions. Thus, nicotinamide may provide a much needed neuroprotective treatment against human glaucoma. This manuscript summarizes human data implicating mitochondria in glaucoma, and argues for studies to further assess the safety and efficacy of nicotinamide in human glaucoma care.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/ijg.0000000000000767

Cites

105 of 105 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

3 of the 108 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [95]Krishnamoorthy RR Rao VR Dauphin R Prasanna G Johnson C Yorio T Role of the ETB receptor in retinal ganglion cell death in glaucoma Can J Physiol Pharmacol 2008 86 380 393 18516102

Cited by

Sorted by citations

Authors
Williams, P. A., Harder, J. M., & John, S. W. M.
Affiliations
  • Howard Hughes Medical Institute (US)
  • Tufts University (US)
Corresponding author
  • Williams, Pete A.
  • Harder, Jeffrey M.
  • John, Simon W.M.
Venue
Journal of Glaucoma
Published
2017-12
Volume
26
Issue
12
Pages
1161-1168
ISSN
1057-0829 (ISSN-L)
OpenAlex
W2753388315
Cited by
102
References
108
Citations by year
2026: 10 · 2025: 14 · 2024: 8 · 2023: 17 · 2022: 12 · 2021: 19 · 2020: 13 · 2019: 5 · 2018: 4
FWCI
1.10
Type
journal article
Language
en
Open access
Locations
  • Journal of Glaucoma (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • The Mouseion at the JAXlibrary (Jackson Laboratory) (submittedVersion)
Funders
  • Howard Hughes Medical Institute
  • National Eye Institute (R01EY011721)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD007065)
Topics
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
  • Life Sciences › Neuroscience › Neurology › Neurological Disorders and Treatments
Keywords
glaucoma, nicotinamide, NAD+, mitochondrial dysfunction, retinal ganglion cells, intraocular pressure, neuroprotection, NAD+ precursors, glaucoma prevention
MeSH terms
Animals, Glaucoma, Humans, Intraocular Pressure, Niacinamide, Optic Nerve Diseases, Vitamin B Complex

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review