{
  "abstract": "Background/Aims The neuroprotective effect of nicotinamide (NAM) supplementation has been demonstrated in both animal models and clinical trials. We conducted a trial to assess whether oral NAM improves retinal function in normal-tension glaucoma (NTG) participants receiving intraocular pressure (IOP)-lowering therapy.Methods Fifty-three NTG participants (untreated IOP ≤18 mm Hg) were enrolled in a double-masked, placebo-controlled crossover randomised clinical trial. Participants were randomly assigned to receive either oral placebo or NAM, followed by crossover without a washout period. Each treatment was administered for 12 weeks (NAM/placebo 1 g/day for 6 weeks, then 2 g/day for the subsequent 6 weeks). Retinal function was evaluated using full-field electroretinography and visual field testing.Results After 12 weeks, the amplitude changes of the photopic negative response in peak-to-trough (PhNRPT) and the B-wave were significantly greater in the NAM group (3.121±3.968 and 2.112±3.220 μV, respectively) compared with the placebo group (0.996±4.190 and 0.305±3.279 μV, respectively; p=0.045 and p=0.032). PhNRPT improved beyond twice the 95% coefficient of variation in 29.0% of the NAM group and 19.3% of the placebo group. No significant intergroup differences were observed in changes in mean deviation, pattern SD or visual field index after 12 weeks.Conclusion Oral NAM supplementation in NTG participants induced functional improvement, as measured by PhNRPT and B-wave amplitude. Given that NTG is characterised by lower IOP, which may show a weaker correlation with electrophysiological activity and a slower progression rate compared with high-tension glaucoma, further long-term studies are needed to clarify the effects of NAM in this population.Trial registration number NCT06078605.",
  "authors": [
    {
      "affiliations": [
        "Department of Ophthalmology, Jeju University Hospital, Jeju University, Jeju, Republic of Korea"
      ],
      "name": "Ahnul Ha"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Seoul National University Hospital, Seoul National University, Seoul, Republic of Korea"
      ],
      "name": "Young Kook Kim"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Ulsan University Hospital, Ulsan University, Ulsan, Republic of Korea"
      ],
      "name": "Chang Kyu Lee"
    },
    {
      "affiliations": [
        "Division of Eye and Vision, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Pete A Williams"
    },
    {
      "affiliations": [
        "School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff, Wales, UK",
        "University Hospital of Wales, Heath Park, Cardiff, Wales, UK"
      ],
      "name": "James E Morgan"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Republic of Korea"
      ],
      "name": "Young In Shin"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea"
      ],
      "name": "Eunsol Kim"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea"
      ],
      "name": "Myungjin Kim"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea"
      ],
      "name": "Seungsoo Rho"
    }
  ],
  "title": "Effects of nicotinamide supplementation in normal-tension glaucoma: a crossover placebo-controlled randomised clinical trial",
  "uid": "000030e0-1898-5380-8eb9-9bbf9a88843d"
}