Abstract #90166 Published in IGR 21-3

Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebo-controlled Clinical Trial

Rossetti L; Iester M; Tranchina L; Ottobelli L; Coco G; Calcatelli E; Ancona C; Cirafici P; Cirafici P; Manni G
Journal of Glaucoma 2020; 29: 513-520

See also comment(s) by Louis Pasquale & Jessica Tran

PRECIS: Citicoline eyedrops in patients with progressing glaucoma. PURPOSE: This study aimed to test whether the additional therapy with citicoline eyedrops to intraocular pressure (IOP)-lowering treatment could slow glaucoma progression in patients with worsening of damage and IOP 18 mm Hg or less. DESIGN: This was a randomized, double-masked, placebo-controlled, multicenter 3-year study. OUTCOMES: The outcomes studied were difference in the visual field (mean deviation, MD, of 24-2; MD of 10-2) rates of progression and difference in retinal nerve fiber layer (RNFL) thickness change between the 2 study groups at 3 years. METHODS: Patients with mild to moderate open-angle glaucoma (OAG) showing damage progression of at least -0.5 dB/y in the 2 years before enrollment despite IOP ≤18 mm Hg were randomized to receive citicoline eyedrops or placebo 3 times daily for 3 years. Patients were followed every 3 months and underwent a visual field examination with 24-2 and 10-2 strategies and RNFL assessment. Analysis of variance and linear models were used to test the differences between groups. RESULTS: Eighty patients were randomized in the trial. The mean 3-year rates of progression were -1.03 (2.14) dB in the citicoline group and -1.92 (2.23) dB in the placebo group (P=0.07) for 24-2 MD and -0.41 (3.45) dB in the citicoline group and -2.22 (3.63) dB in the placebo group (P=0.02) for 10-2 MD. On average, patients receiving citicoline eyedrops lost 1.86 μm of RNFL in 3 years, versus 2.99 μm in the placebo group (P=0.02). CONCLUSIONS: Additional treatment with citicoline eyedrops to IOP-lowering treatment might reduce disease progression in patients with progressing glaucoma despite IOP ≤18 mm Hg.

Eye Clinic, ASST Santi Paolo e Carlo, University of Milan, Milan.

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11.14 Investigational drugs; pharmacological experiments (Part of: 11 Medical treatment)
11.8 Neuroprotection (Part of: 11 Medical treatment)
6.20 Progression (Part of: 6 Clinical examination methods)

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