Nicola Constantin Alin, Marinescu Maria Cristina, Firan Anne Marie, Tartea Georgica, Naidin Mihaela Simona, Ciuluvica Radu Constantin, Dimulescu Marina Daniela, Voicu Nicoleta Mirela, Mihailescu Carmen Marinela, Meca Andreea-Daniela, Bogdan Maria, Turcu-Stiolica Adina
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Discipline of Medical Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Nutrients. 2025 Aug 27;17(17):2775. doi: 10.3390/nu17172775.
Glaucoma is the primary cause of irreversible blindness worldwide, with enormous impact on quality of life and activities of daily living. Since one pathogenic mechanism of glaucoma is mitochondrial dysfunction at the retinal ganglion cell level, niacin has been proposed as an adjuvant treatment, with encouraging results. The objective of this prospective, non-randomized, single-arm clinical trial was to investigate the effect of oral supplementation with niacin on the quality of life of a cohort of glaucoma patients in Romania. Fifty-eight patients diagnosed with primary open angle glaucoma, under topical hypotensive treatment, were evaluated before and after a 6-month period of daily administration of 500 mg of oral niacinamide. Evaluation involved a complete ophthalmological exam and QoL quantification using the Glaucoma Quality of Life-15 (GQL-15) Questionnaire. We found strong evidence that niacin supplementation for 6 months led to a statistically significant improvement in QoL scores among glaucoma patients (mean difference = -2.10, 95% CI: [-2.89, -1.32], < 0.0001), including central and near vision (mean difference = -2.16, 95% CI: [-3.91, -0.4], = 0.017), peripheral vision (mean difference = -2.66, 95% CI: [-0.23, -0.08], < 0.001), and the glare and dark adaptation (mean difference = -5.24, 95% CI: [-0.33, -0.14], < 0.001). In addition, B3 treatment resulted in a significant reduction in intraocular pressure in both eyes over 6 months (mean difference = 0.53, 95% CI: [0.21, 0.86] in the left eye and mean difference = 0.36, 95% CI: [0.04, 0.68] in the right eye), indicating potential clinical benefits. The observed GQL-15 score reductions suggest that B3 may be of benefit in glaucoma management. Further research with larger sample sizes and placebo-controlled designs is needed to confirm B3 potential impact on disease progression and quality of life. Trial Registration at clinicaltrials.gov: NCT07007260.
青光眼是全球不可逆性失明的主要原因，对生活质量和日常生活活动有巨大影响。由于青光眼的一种致病机制是视网膜神经节细胞水平的线粒体功能障碍，烟酸已被提议作为辅助治疗方法，且取得了令人鼓舞的结果。这项前瞻性、非随机、单臂临床试验的目的是研究口服补充烟酸对罗马尼亚一组青光眼患者生活质量的影响。58名被诊断为原发性开角型青光眼且正在接受局部降压治疗的患者，在每天服用500毫克口服烟酰胺6个月前后接受了评估。评估包括全面的眼科检查和使用青光眼生活质量-15（GQL-15）问卷进行生活质量量化。我们发现有力证据表明，补充烟酸6个月导致青光眼患者的生活质量评分有统计学意义的改善（平均差异=-2.10，95%置信区间：[-2.89，-1.32]，P<0.0001），包括中心视力和近视力（平均差异=-2.16，95%置信区间：[-3.91，-0.4]，P=0.017）、周边视力（平均差异=-2.66，95%置信区间：[-0.23，-0.08]，P<0.001）以及眩光和暗适应（平均差异=-5.24，95%置信区间：[-0.33，-0.14]，P<0.001）。此外，B3治疗在6个月内使双眼眼压显著降低（左眼平均差异=0.53，95%置信区间：[0.21，0.86]；右眼平均差异=0.36，95%置信区间：[0.04，0.68]），表明有潜在的临床益处。观察到的GQL-15评分降低表明B3可能对青光眼治疗有益。需要进行更大样本量和安慰剂对照设计的进一步研究，以证实B3对疾病进展和生活质量的潜在影响。在clinicaltrials.gov上的试验注册：NCT07007260。
