Cited by 227Glaucoma and retinal disordersRetinal Diseases and TreatmentsNeurological Disorders and Treatments

Improvement in inner retinal function in glaucoma with nicotinamide (vitamin B3 ) supplementation: A crossover randomized clinical trial

Open access
Hui, Flora, Tang, Jessica, Williams, Pete A., McGuinness, Myra B., Hadoux, Xavier, Casson, Robert J., Coote, Michael, Trounce, Ian A. +3 more·2020·Clinical & Experimental Ophthalmology

Published version of a preprint

Abstract

Importance: Retinal ganglion cells endure significant metabolic stress in glaucoma but maintain capacity to recover function. Nicotinamide, a precursor of NAD + , is low in serum of glaucoma patients and its supplementation provides robust protection of retinal ganglion cells in preclinical models. However, the potential of nicotinamide in human glaucoma is unknown. Background: To examine the effects of nicotinamide on inner retinal function in glaucoma, in participants receiving concurrent glaucoma therapy. Design: Crossover, double‐masked, randomized clinical trial. Participants recruited from two tertiary care centres. Participants: Fifty‐seven participants, diagnosed and treated for glaucoma. Methods: Participants received oral placebo or nicotinamide and reviewed six‐weekly. Participants commenced 6 weeks of 1.5 g/day then 6 weeks of 3.0 g/day followed by crossover without washout. Visual function measured using electroretinography and perimetry. Main outcome measures: Change in inner retinal function, determined by photopic negative response (PhNR) parameters: saturated PhNR amplitude (Vmax), ratio of PhNR/b‐wave amplitude (Vmax ratio). Results: PhNR Vmax improved beyond 95% coefficient of repeatability in 23% of participants following nicotinamide vs 9% on placebo. Overall, Vmax improved by 14.8% [95% CI: 2.8%, 26.9%], ( P = .02) on nicotinamide and 5.2% [−4.2%, 14.6%], ( P = .27) on placebo. Vmax ratio improved by 12.6% [5.0%, 20.2%], ( P = .002) following nicotinamide, 3.6% [−3.4%, 10.5%], ( P = .30) on placebo. A trend for improved visual field mean deviation was observed with 27% improving ≥1 dB on nicotinamide and fewer deteriorating (4%) compared to placebo ( P = .02). Conclusions: Nicotinamide supplementation can improve inner retinal function in glaucoma. Further studies underway to elucidate the effects of long‐term nicotinamide supplementation.

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Authors
Hui, F., Tang, J., Williams, P. A., McGuinness, M. B., Hadoux, X., Casson, R. J., Coote, M., Trounce, I. A., Martin, K. R., van Wijngaarden, P., & Crowston, J. G.
Affiliations
  • The Royal Victorian Eye & Ear Hospital (AU)
  • The University of Melbourne (AU)
  • Karolinska Institutet (SE)
  • The University of Adelaide (AU)
  • Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital Melbourne Australia
Corresponding author
Hui, Flora
Venue
Clinical & Experimental Ophthalmology
Publisher
Wiley
Published
2020-07-28
Volume
48
Issue
7
Pages
903-914
ISSN
  • 1442-6404 (ISSN-L)
  • 1442-9071
OpenAlex
W3045788107
Cited by
226
References
56
Citations by year
2026: 39 · 2025: 40 · 2024: 44 · 2023: 40 · 2022: 30 · 2021: 26 · 2020: 7
FWCI
20.26
Type
journal article
Language
en
Open access
Locations
  • Clinical and Experimental Ophthalmology (publishedVersion)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders
  • Jack Brockhoff Foundation (4354 ‐ 2017)
  • Ophthalmic Research Institute of Australia
  • Vetenskapsrådet (2018‐02124)
Topics
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Life Sciences › Neuroscience › Neurology › Neurological Disorders and Treatments
Keywords
glaucoma, nicotinamide, inner retinal function, photopic negative response, electroretinogram, retinal ganglion cells, visual field mean deviation, neuroprotection
MeSH terms
Electroretinography, Glaucoma, Glaucoma, Open-Angle, Humans, Niacinamide, Photic Stimulation, Retina, Dietary Supplements

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