2020 Jul 29
Citicoline Eyedrops for Glaucoma
Investigators assessed whether additional therapy with citicoline eyedrops to intraocular pressure-lowering treatment could slow glaucoma progression in patients with worsening of damage and IOP 18 mmHg or less, as part of a randomized, double-masked, placebo-controlled, multicenter three-year study.
Main outcome measures were differences in visual field (MD of 24-2; MD of 10-2) rates of progression and differences in retinal nerve fiber layer thickness changes between the two study groups at three years.
Patients with mild to moderate open-angle glaucoma showing damage progression of at least -0.5 dB/y in the two years before enrollment despite IOP ≤18 mmHg were randomized to receive citicoline eyedrops or placebo three times daily for three years. Patients were followed every three months and underwent visual field exams with 24-2 and 10-2 strategies and RNFL assessment. ANOVA and linear models were used to test the differences between groups.
Eighty patients were randomized in the trial. Here were some of the findings:
Mean three-year rates of progression were:
for 24-2 MD: -1.03 (2.14) dB in the citicoline group and -1.92 (2.23) dB in the placebo group (p=0.07); and
for 10-2 MD -0.41: (3.45) dB in citicoline group and -2.22 (3.63) dB in the placebo group (p=0.02).
On average patients receiving citicoline eye drops lost 1.86 µm of RNFL in three years vs. 2.99 µm in the placebo group (p=0.02).
Investigators concluded that adding treatment with citicoline eye drops to IOP-lowering treatment might reduce disease progression in individuals with progressing glaucoma despite IOP ≤18 mmHg.
SOURCE: Rossetti L, Iester M, Tranchina L, et al. Can treatment with citicoline eyedrops reduce progression in glaucoma? The results of a randomized placebo-controlled clinical trial. J Glaucoma 2020; June 11. [Epub ahead of print].