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Australian glaucoma trial set to expand after vitamin B3 success

Daily doses of vitamin B3 can lead to significant improvements in glaucoma patients who are also receiving regular treatments to lower eye pressure, new results of a world-first study have revealed.

The clinical trial led by Melbourne’s Centre for Eye Research Australia (CERA) has shown that vitamin B3 (nicotinamide) could play an important role in protecting against nerve cell damage that leads to blindness in glaucoma.

Results of the trial, led by Professor Jonathan Crowston and Dr Flora Hui at CERA, show significant improvement in the visual function of glaucoma patients who received a daily high dose of 3 grams of nicotinamide for 12 weeks in addition to their regular treatment to reduce eye pressure.

Announcing the results on 29 July, CERA said earlier pre-clinical research in the US showed that vitamin B3 could prevent optic nerve degeneration but this is the first time similar results have been witnessed in a human trial.

“For the first time, we have shown that daily high doses of vitamin B3 can lead to early and significant improvements in patients who are also receiving traditional treatments to lower eye pressure,’’ Hui said.

“As a safe therapy that is well tolerated by patients, vitamin B3 has potential as a clinical supplement to support patients who are receiving glaucoma treatment.’’

She said a larger international trial was now needed to determine if the improvement shown in this study could be sustained over the longer term to reduce the progression of glaucoma.

Delaying progression

CERA’s trial involved 57 glaucoma patients from private ophthalmic clinics in Melbourne and the Royal Victorian Eye and Ear Hospital. All received both placebo and vitamin B3 over the course of the study.

Patients’ visual function was tested using electroretinography, a diagnostic test which measures electrical activity in the cells of the retina, and visual field testing to determine any changes in vision.

CERA said the trial found that in some people, high-dose nicotinamide significantly improved how nerve cells were functioning in the eye.

A larger trial is now being planned to assess whether these improvements can help reduce disease progression over a longer period.

“We now need a longer-term study to know conclusively whether nicotinamide delays glaucoma progression more than simply using eye pressure lowering medications alone,’’ Professor Jonathan Crowston, who led the study at CERA, said.

“A larger study will help us determine whether vitamin B3 should be taken on an ongoing basis by glaucoma patients.”

Researchers from the University of Melbourne, Duke NUS-Medical School, Singapore Eye Research Institute, Karolinska Institutet, University of Adelaide and Cambridge University are also involved in the study.

Results of the trial were published this month in Clinical and Experimental Ophthalmology.