Blackmores Institute

Published in the journal, Clinical Experimental Ophthalmology, the prospective, double-blind, randomised, crossover clinical trial investigated the use of high dose nicotinamide (NAM) in 49 people diagnosed with glaucoma and found inner retinal function - determined by photopic negative response (PhNR) parameters: saturated PhNR amplitude (Vmax), ratio of PhNR/b-wave amplitude (Vmax ratio) - were significantly improved in the high-dose NAM arm, with (PhNR Vmax) and 21 percent (Vmax ratio) of the group improving beyond the respective 95% coefficient of repeatability for each measure. “Glaucoma remains the leading cause of irreversible blindness worldwide. The disease has a complex aetiology and range of risk factors but is characterised by gradual dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve,” the authors explained.“Age, genetics and elevated intraocular pressure (IOP) are all major risk factors for glaucoma yet clinically available treatment strategies target only IOP-lowering, and do not directly target the neurodegenerative events at the level of the retina and optic nerve.”“Nicotinamide adenine dinucleotide (NAD+) is a potent mediator of axon neuroprotection and recently, the therapeutic potential of modulating NAD+ metabolism has gained widespread attention in its role in ageing and neurodegenerative disease. Recent work has indicated that patients with primary open-angle glaucoma (POAG) have reduced serum levels of NAM (the amide of vitamin B3 and precursor for NAD+), indicating that systemic NAD+ levels may be associated with susceptibility to glaucoma.”With study dosage derived from preclinical work and clinical trials of the supplement for other indications, Blackmores Insolar 0.5g NAM tablets was used to treat study participants in a six-week course of 1.5g/day NAM followed by six weeks of 3.0g/day (1.5g twice a day).Following 12 weeks of NAM supplementation, the study reported 27 percent of patients demonstrated an improvement in visual field mean deviation, and fewer deteriorated compared to the placebo group. “We provide evidence that NAM can lead to an early improvement in inner retinal function in a significant proportion of IOP-treated glaucoma patients after 12 weeks of supplementation. “Overall, NAM was well tolerated with an adherence rate of &gt;94%. As systemic NAM levels have been shown to be reduced in patients with primary open angle glaucoma POAG, NAM supplementation may be a convenient, safe and cost-effective therapy in conjunction with existing IOP- lowering strategies. A longer-term study is being planned to determine whether these functional improvements are sustained and associated with delayed glaucoma progression,” the authors concluded.Source:
 Clin Experiment Ophthalmol. 2020. DOI: <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/ceo.13818 ">10.1111/ceo.13818 </a>

Australian researchers have found that supplementation with nicotinamide can improve inner retinal function in people with glaucoma.

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