Dr Flora Hui.

A WORLD-FIRST clinical trial led by the Centre for Eye Research Australia (CERA) shows vitamin B3 (nicotinamide) could play an important role protecting against nerve cell damage that leads to blindness from glaucoma.

Heading up the CERA study, Dr Flora Hui said her research team observed “significant improvement” in the visual function of glaucoma patients who received a high daily dose of 3g of nicotinamide for 12 weeks in addition to their regular treatment to reduce intraocular pressure.

The trial involved 57 glaucoma patients. Participants received oral placebo or nicotinamide and were reviewed six‐weekly; function was measured using electroretinography and perimetry.

The results showed high-dose nicotinamide significantly improved how nerve cells functioned in some participants’ eyes, with the photopic negative response maximal velocity (PhNR Vmax) improving in 23% of participants given nicotinamide compared with 9% on placebo. Overall, Vmax improved by 14.8% (P = .02) with nicotinamide and 5.2% (P = .27) with placebo. A trend for improved visual field mean deviation was also observed.

Study co-lead Professor Jonathan Crowston, now at Duke-NUS Medical School, said the short-term improvement in retinal function was exciting. “We now need a longer-term study to know conclusively whether nicotinamide delays glaucoma progression more than simply using eye pressure lowering medications alone.”

https://onlinelibrary.wiley.com/doi/full/10.1111/ceo.13818