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.
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.
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.
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).
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