I'm sharing excerpts from an editorial in Clinical and Experimental Ophthalmology.
For multiple decades, treatment of glaucoma has focused on the reduction of intraocular pressure.
Note: This remains the only widely-accepted medical treatment and it remains as essential as ever.
Introduction of nicotinamide [vitamin B3] into the glaucoma clinic has occurred remarkably quickly. Just 3 years ago, Williams et al published a highly significant report in Science, in which they demonstrated that mitochondrial dysfunction and reduced levels of NAD+ occurred early in retinas of glaucoma-prone mice, and that addressing this defect -- by methods that included supplementing the diet with nicotinamide -- had preventive and therapeutic effects in the mice.
Subsequently, an independent group reported lower levels of nicotinamide in patients with primary open-angle glaucoma. In response to this ground-breaking discovery, Liebmann and Cioffik published a perspective in the New England Journal of Medicine entitled, “Nicking Glaucoma with Nicotinamide?”, which ended with the question, “Should nicotinamide be tested in humans with glaucoma?” [Emphasis added.]
A "carefully designed and executed clinical trial" conducted by a team of largely Australian-based ophthalmologists, "addresses this question and provides strong evidence that the answer may be yes.”
We are now faced with the very real possibility that "protecting retinal ganglion cells -- and preventing progression of, or even reversing, glaucoma," could involve a vitamin B3 supplement (in addition to managing intraocular pressure).
Hui et al indicate plans for an extended clinical trial “to determine whether (the) functional improvements (linked to nicotinamide supplements) are sustained and associated with delayed glaucoma progression.”
Some glaucoma specialists are already recommending nicotinamide (a common and inexpensive form of vitamin B3) to their patients. Multiple clinical trials are underway. I know of one using nicotinamide (NAM) and one involving nicotinamide riboside (NR).
- Clin Experiment Ophthalmol. 2020;48:877–878.
- DOI: 10.1111/ceo.13849
- pub: 2020