Effects of oral citicoline in perimetric glaucoma defects

Abstract: Purpose: to study the neuroprotective effect of oral citicoline (CT) in patients with primary open-angle glaucoma (POAG). Methods: this study recruits 110 patients with stage IV POAG and well-controlled intraocular pressure (IOP). Enrollees were randomly allocated in two groups: therapy group (TG) or control group (CG). Subjects in TG were treated with citicoline 500 mg / die for 4 months. The treatment period was followed by a wash-out phase of 2 months. At the end of the washout phase, subjects in TG resumed CT in the same fashion. Both groups were treated with pressurelowering medications. Each subject was evaluated with standard automated perimetry (SAP) at baseline, and then again 12, 24, and 36 months after enrollment. Results: TG showed a statistically significant improvement in MD values at 12 months (∆ = 21%) and T24 (∆ = 35%), and gradual improvements of the stage, up to the 3rd stage with localized defects after 36 months of therapy. Conversely, in CG, both the MD and PSD indices continued to deteriorate throughout the duration of the study. Conclusion: long-term daily treatment with citicoline might have a neuroprotective effect. Patients treated with oral citicoline showed an improvement in perimetric indices. Additional studies with larger samples and longer follow-ups are needed to confirm these results.