Citicoline, an endogenous compound, is a new therapeutic agent for glaucoma.
Recent clinical studies have investigated the neuroprotective effects of citicoline on glaucoma in intramuscular, oral, and topical eye drop formulations.
Girardi et al. described the neuronutritional properties of citicoline for POAG, in which patients who took 1g citicoline IM daily for 10 days showed significant improvement on visual field tests despite good IOP control.
These therapeutic effects lasted for at least 3 months and were maintained with retreatment.
Girardi and the researchers also evaluated the protective effects of citicoline by repeating treatment every six months and found that the benefits of vision lasted for more than 10 years.
The rate of visual field deterioration in the treatment and control groups was 10% and 50%, respectively.
Placebo-controlled studies have also shown that intramural citicular choline significantly improves retinal cortical function as measured by visual evoked potential (VEP) and graphic ERG (PERG).
The researchers first evaluated the neuroprotective effects of oral citicoline in glaucoma.
The longitudinal study further evaluated the benefit of oral citicoline in patients with progressive POAG despite control of intraocular pressure.
Patients who received oral citicoline 500 mg daily for 2 years (4-month cycles with 2-month washout intervals) had a significantly lower rate of glaucoma progression.
Other studies have reported delayed glaucoma lesions in retinal morphology with significant improvement in OCT thickness measurements of retinal nerve fiber layers and ganglion cell complexes by oral citicoline therapy.
Interestingly, the significance of these results did not become apparent until 1 year after citicoline treatment, suggesting that prolonged treatment is needed to achieve clinically meaningful effects.
Parisi et al. compared the efficacy of oral versus intramuscular citicoline and reported similar improvements in retinal function and nerve conduction along visual pathways in both preparations.
Continuous treatment for up to eight years stabilized or further improved visual dysfunction in patients with glaucoma, suggesting that repeated dosing is needed to achieve optimal results.
Topical administration of citicoline eye drops may also improve retinal function and nerve conduction along visual pathways.
With little or no side effects and improved adherence, oral citicoline is the preferred route of administration.
Citicoline has been authorized as a food supplement in the European Union, the Italian Ministry of Health and the United States.
Citicoline is a new food ingredient approved by the European Union and the Italian Ministry of Health for use in food supplements for glaucoma patients and dietary foods for special medical purposes.
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