WeeklySA_AdminVISION: A large US study suggests nicotinamide, a form of vitamin B3, could cut the risk of developing glaucoma by 66% in people with high eye pressure, offering fresh hope for preventing the world’s leading cause of irreversible blindness…
By Sanjukta Mondal
Often called the silent thief of sight, glaucoma is a group of eye diseases that gradually damage the optic nerve, often without warning signs.
It is linked to increased pressure (ocular hypertension) inside the eye and, if left untreated, can lead to permanent vision loss. Even with ongoing treatment, some people still face the risk of progressive vision loss.
This led scientists to look for newer therapeutics that can help manage the disease’s progression, such as nicotinamide, a form of vitamin B3. In a recent study, researchers conducted a large-scale data analysis to investigate whether nicotinamide could help prevent or delay the onset of primary open-angle glaucoma (POAG) in high-risk patients.
They identified 2 920 patients who had ocular hypertension but had not yet developed glaucoma; half were taking nicotinamide, and the others were not. The comparison revealed that those taking the vitamin had a 66% lower risk of developing glaucoma. Over about 3.7 years, only 3.5% of nicotinamide users developed the disease, compared with 9% of nonusers. The findings were published in JAMA Ophthalmology.
Scientists have recently realised that glaucoma is a metabolic disease. As people age, their levels of a molecule called nicotinamide adenine dinucleotide—a coenzyme that helps cells produce energy and repair DNA—naturally drop, leaving retinal cells in the eye short on energy and vulnerable to damage. Nicotinamide helps replenish this coenzyme and subsequently supports repair and improved blood flow in the eyes. So far, most studies have focused on whether nicotinamide supplements can protect damaged optic nerve cells and improve vision in people with glaucoma.
What researchers didn’t know was whether the supplement could also help prevent the disease from developing in people with ocular hypertension. For this study, researchers analysed anonymous electronic health records collected from 67 health care organizations across the United States over 20 years, from March 2006 to March 2026. They focused on people with ocular hypertension who had not yet been diagnosed with glaucoma.
To make the comparison as fair as possible, they used a method called propensity score matching, pairing each person taking nicotinamide with a closely matched participant of the same age, sex, medical history and eye condition who was not taking the supplement.
They tracked the two matched groups for 3.7 years to answer three main questions: Did participants officially develop glaucoma? Did they need to start using prescription eye drops to lower eye pressure?
Did they require laser therapy?
High-risk patients taking nicotinamide were significantly less likely to develop glaucoma or need more intensive treatment than those who did not take the supplement. Only 13.6% of people in the nicotinamide group needed prescription eye drops to lower eye pressure, compared with 21.2% of those who were not taking it.
Those who did not take the supplement were also more than twice as likely to require laser treatment for glaucoma. The protective effect was seen even among patients who started taking nicotinamide only after being diagnosed with high eye pressure.
While nicotinamide is not a replacement for standard glaucoma care, these findings suggest it could help delay the onset of POAG and reduce the need for treatment after diagnosis. Since this was an observational study, it cannot prove that nicotinamide was directly responsible for the benefits.
Larger studies are still needed to establish these effects and determine its safety, the most effective dose and its long-term impact before it can be considered a reliable addition to existing eye care. – Medical Express
