School of Medicine, Queen's University, Kingston, ON K7L 3N6, Canada.
Department of Ophthalmology, Kingston Health Science Centre, Queen's University, Kingston, ON K7L 5G2, Canada.
Nutrients. 2024 Aug 21;16(16):2795. doi: 10.3390/nu16162795.
Glaucoma and age-related macular degeneration (AMD) are progressive retinal diseases characterized by increased oxidative stress, inflammation, and mitochondrial dysfunction. This review investigates the potential therapeutic benefits of NAD+ and niacin supplementation in managing glaucoma and AMD. A literature search was conducted encompassing keywords such as "niacin", "NAD", "glaucoma", "AMD", and "therapeutics". NAD+ depletion is associated with increased oxidative stress and mitochondrial dysfunction in glaucoma and AMD. Niacin, a precursor to NAD+, has shown promise in replenishing NAD+ levels, improving choroidal blood flow, and reducing oxidative damage. Animal studies in glaucoma models indicate that nicotinamide (NAM) supplementation preserves RGC density and function. Large-scale population-based studies indicate an inverse correlation between niacin intake and glaucoma prevalence, suggesting a preventative role. Randomized controlled trials assessing niacin supplementation showed significant improvements in visual field sensitivity and inner retinal function, with a dose-dependent relationship. In AMD, nicotinamide supplementation may improve rod cell function and protect against oxidative stress-induced damage. Cross-sectional studies reveal that individuals with AMD have a lower dietary intake of niacin. Further studies suggest niacin's role in improving choroidal blood flow and dilating retinal arterioles, potentially mitigating ischemic damage and oxidative stress in AMD. Beyond current management strategies, NAD+ and niacin supplementation may offer novel therapeutic avenues for glaucoma and AMD. Further research is warranted to elucidate their efficacy and safety in clinical settings.
青光眼和年龄相关性黄斑变性（AMD）是两种进行性视网膜疾病，其特征为氧化应激增加、炎症和线粒体功能障碍。本综述探讨了 NAD+和烟酰胺补充剂在治疗青光眼和 AMD 方面的潜在治疗益处。通过包含“烟酰胺”、“NAD”、“青光眼”、“AMD”和“治疗”等关键词进行文献检索。NAD+耗竭与青光眼和 AMD 中的氧化应激增加和线粒体功能障碍有关。烟酰胺是 NAD+的前体，已显示出在补充 NAD+水平、改善脉络膜血流和减少氧化损伤方面有潜力。青光眼模型中的动物研究表明，烟酰胺（NAM）补充可维持 RGC 密度和功能。大规模基于人群的研究表明，烟酰胺摄入与青光眼患病率呈负相关，提示其具有预防作用。评估烟酰胺补充的随机对照试验显示，视野敏感性和内视网膜功能有显著改善，且呈剂量依赖性。在 AMD 中，烟酰胺补充可能改善视杆细胞功能并防止氧化应激诱导的损伤。横断面研究表明，AMD 患者的烟酰胺膳食摄入量较低。进一步的研究表明，烟酰胺在改善脉络膜血流和扩张视网膜小动脉方面发挥作用，可能减轻 AMD 中的缺血性损伤和氧化应激。除了目前的治疗策略外，NAD+和烟酰胺补充剂可能为青光眼和 AMD 提供新的治疗途径。需要进一步研究以阐明其在临床环境中的疗效和安全性。
