Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/130300
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Type: | Journal article |
Title: | Improvement in inner retinal function in glaucoma with nicotinamide (vitamin B3) supplementation: A crossover randomized clinical trial |
Author: | 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. |
Citation: | Clinical and Experimental Ophthalmology, 2020; 48(7):903-914 |
Publisher: | Wiley |
Issue Date: | 2020 |
ISSN: | 1442-6404 1442-9071 |
Statement of Responsibility: | Flora Hui, Jessica Tang, Pete A. Williams, Myra B. McGuinness, Xavier Hadoux, Robert J. Casson, Michael Coote, Ian A. Trounce, Keith R. Martin, Peter van Wijngaarden, Jonathan G. Crowston |
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. |
Keywords: | electroretinography glaucoma neuroprotection nicotinamide vitamin B3 |
Rights: | © 2020 Royal Australian and New Zealand College of Ophthalmologists |
DOI: | 10.1111/ceo.13818 |
Published version: | http://dx.doi.org/10.1111/ceo.13818 |
Appears in Collections: | Aurora harvest 4 Opthalmology & Visual Sciences publications |
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hdl_130300.pdf | Submitted version | 3 MB | Adobe PDF | View/Open |
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