AUTHOR=Lanza Michele , Gironi Carnevale Ugo Antonello , Mele Luigi , Bifani Sconocchia Mario , Bartollino Silvia , Costagliola Ciro 

TITLE=Morphological and Functional Evaluation of Oral Citicoline Therapy in Chronic Open-Angle Glaucoma Patients: A Pilot Study With a 2-Year Follow-Up

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2019.01117

DOI=10.3389/fphar.2019.01117

ISSN=1663-9812

ABSTRACT=Aims: To study the neuroprotective effect of oral citicoline (CT) therapy in primary open angle glaucoma (POAG). 
Methods: One eye of sixty POAG patients were included in this study.  Patients were randomly divided into 2 groups (A and B) of 30 participants each. Only patients of group A were supplemented with CT therapy.Age, sex and disease duration were matched between groups. Despite a stable intraocular pressure (IOP), a slow disease progression - assessed by standard automated white on white perimetry (SAP) in the previous 3 years - occurred in all patients. All patients underwent a complete eye examination including IOP measurement, SAP, retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness measurements with optical coherence tomography (OCT), before starting CT treatment and at 6, 12, 18 and 24 months follow up. Parameters differences between groups were evaluated at each eye check. 
Results: After 18 months, mean values of SAP mean deviation (MD) of group A were significantly (p=0.039) higher (-7.25 db) compared to group B (-8.64 db) ones. Moreover, they appeared stable in the following visits whereas, in group B, mean MD values continued to significantly (p<0.001) decrease (-9.28 db) over time. Mean RNFL and GCC thickness in group A were significantly (p<0.01) higher (70.39 microns and 71.19 microns respectively) compared to group B ones (64.91 microns and 65.60 microns respectively) after 12 months of CT therapy. Furthermore, they appeared to be stable over the later visits, whereas they significantly (p<0.001) thinned over time in group B. 
Conclusion: These findings suggest that CT therapy seems to be effective in slowing POAG progression. Further studies on a larger population and with a longer follow-up are needed to confirm this pilot investigation.