Efficacy of citicoline as a supplement in glaucoma patients: A systematic review

Glaucoma is a leading cause of irreversible blindness worldwide. Retinal ganglion cells (RGC), the neurons that connect the eyes to the brain, specifically die in glaucoma, leading to blindness. Elevated intraocular pressure (IOP) is the only modifiable risk factor, however, many patients progress d...

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Bibliographic Details
Published in:PloS one 2023-09, Vol.18 (9), p.e0291836-e0291836
Main Authors: Prinz, Julia, Prokosch, Verena, Liu, Hanhan, Walter, Peter, Fuest, Matthias, Migliorini, Filippo
Format: Article
Language:English
Subjects:
Amplitudes
Bias
Biology and Life Sciences
Blindness
Care and treatment
Citicoline
Complications and side effects
Cytidine diphosphate choline
Diagnosis
Effectiveness
Glaucoma
Health aspects
Intraocular pressure
Medical research
Medicine and Health Sciences
Medicine, Experimental
Nervous system diseases
Neurodegenerative diseases
Neuroprotection
Patient outcomes
Patients
Research and Analysis Methods
Retina
Retinal ganglion cells
Risk factors
Social Sciences
Software reviews
Systematic review
Visual field
Visual fields
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Summary:Glaucoma is a leading cause of irreversible blindness worldwide. Retinal ganglion cells (RGC), the neurons that connect the eyes to the brain, specifically die in glaucoma, leading to blindness. Elevated intraocular pressure (IOP) is the only modifiable risk factor, however, many patients progress despite excellent IOP control. Thus, alternative treatment strategies to prevent glaucoma progression are an unmet need. Citicoline has demonstrated neuroprotective properties in central neurodegenerative diseases. However, conclusive evidence of the effect of citicoline on glaucoma progression is missing. This systematic review investigates first-time the therapeutic potential of citicoline in glaucoma patients. The present study was conducted according to the PRISMA 2020 statement. PubMed, Web of Science, Google Scholar, and Embase were accessed in July 2023 to identify all clinical studies investigating the efficacy of citicoline on IOP, the mean deviation of the 24-2 visual field testing (MD 24-2), retinal nerve fibre layer (RNFL), and the pattern electroretinogram (PERG) P50-N95 amplitude in glaucoma patients. The risk of bias was assessed using the Review Manager 5.3 software (The Nordic Cochrane Collaboration, Copenhagen) and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool. Ten studies were eligible for this systematic review, including 424 patients. The mean length of the follow-up was 12.1 ± 11.6 months. The overall risk of bias was low to moderate. The mean age of the patients was 56.7 years. There were no significant differences in the IOP, MD 24-2, RNFL, or PERG P50-N95 amplitude between patients receiving citicoline and the control group. There was no improvement from baseline to the last follow-up in IOP, MD 24-2, RNFL, or PERG P50-N95 amplitude. There is a lack of sufficient evidence to support that citicoline slows the progression of glaucoma.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0291836