Citicoline may be adjunctive therapy for improving vision-related QoL in glaucoma patients

A number of reports on glaucoma patients have described difficulties in performing daily activities and loss of vision-related quality of life. Open-angle glaucoma (OAG) is a progressive optic neuropathy and one major cause of global blindness.

The current study aimed to evaluate whether the use of citicoline oral solution could improve quality of life in patients with chronic open-angle glaucoma (OAG).

The study in Graefe's Archive for Clinical and Experimental Ophthalmology was the first placebo-controlled clinical study evaluating the effect of a medical treatment aiming at improving vision-related quality of life in glaucomatous patients.Overall, citicoline therapy was shown to have a greater impact on the Visual Function Questionnaire–25 scores at 6 months compared with placebo use.

Patients with a poorer mean deviation on visual field testing and a worse visual quality at baseline demonstrated the greatest improvement with citicoline therapy. With Short Form–36 questionnaire testing of the general quality of life, no significant improvement was observed with citicoline therapy.

Researchers conducted randomized, double-masked, placebo-controlled, cross-over study was used. Patients were randomized to one of the two sequences: either citicoline 500 mg/day oral solution-placebo or placebo-citicoline 500 mg/day oral solution. Switch of treatments was done after 3 months; patients were then followed for other 6 months. Follow-up included 3-month, 6-month, and 9-month visits.

The key findings of the study are

• The primary pre-specified outcome of the analysis reached statistical significance (p = 0.0413), showing greater improvement after citicoline oral solution.

• There was an increase in the composite score in both arms compared to baseline, but it was significant only for the placebo-citicoline arm (p = 0.0096, p = 0.0007, and p = 0.0006 for the three time-points compared to baseline).

• The effect of citicoline was stronger in patients with vision-related quality of life more affected by glaucoma at baseline.

Researchers concluded that “This is the first placebo-controlled clinical study evaluating the effect of a medical treatment aiming at improving vision-related quality of life in glaucomatous patients.” Citicoline therapy may have a future role as an adjunctive therapy for improving vision-related quality of life in patients with glaucoma.

Reference: Rossetti, L., Goni, F., Montesano, G. et al. The effect of citicoline oral solution on quality of life in patients with glaucoma: the results of an international, multicenter, randomized, placebo-controlled cross-over trial. Graefes Arch Clin Exp Ophthalmol 261, 1659–1668 (2023). https://doi.org/10.1007/s00417-022-05947-5.