Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination

Camillo Cornelio; Lorenzo Crisigiovanni; Virginia Limardo; Davide Nuzzo; Pasquale Troiano

doi:doi:10.11648/j.ijovs.20210602.13

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Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination

Camillo Cornelio, Lorenzo Crisigiovanni, Virginia Limardo, Davide Nuzzo, Pasquale Troiano

Published in International Journal of Ophthalmology & Visual Science (Volume 6, Issue 2)

Received: 16 March 2021 Accepted: 7 April 2021 Published: 16 April 2021

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Abstract

Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: - group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; - group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.

Published in	International Journal of Ophthalmology & Visual Science (Volume 6, Issue 2)
DOI	10.11648/j.ijovs.20210602.13
Page(s)	75-79
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Primary Open-angle Glaucoma, Citicoline, Homotaurine, Vitamin E, PERG

References

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[2]	The AGIS Investigators. (2000). Advanced glaucoma intervention study (AGIS): The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 130 (4): 429-440.
[3]	Heijl A, et al. (2008). A comparison of visual field progression criteria of 3 major glaucoma trials in early manifest glaucoma trial patients. Ophthalmology. 115 (9): 1557-65.
[4]	Bayer AU, et al. (2002). Association of glaucoma with neurodegenerative diseases with apoptotic cell death: Alzheimer's disease and Parkinson's disease. Am J Ophthalmol. 133 (1): 135-7.
[5]	Jutley G, et al. (2017). Management of glaucoma as a neurodegenerative disease. Neurodegener Dis Manag. 7 (2): 157-172.
[6]	Calkins DJ, Horner PJ. (2012). The cell and molecular biology of glaucoma: axonopathy and the brain. Invest Ophthalmol Vis Sci. 53 (5): 2482-4.
[7]	Grieb P, et al. (2016). Citicoline: A Food Beneficial for Patients Suffering from or Threated with Glaucoma. Front Aging Neurosci. 8: 73. doi: 10.3389/fnagi.2016.00073
[8]	Secades JJ. (2016). Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol. 63 (S03): S1-S73.
[9]	Parisi V, et al. (1999). Cytidine-5’-Diphosphocholine (Citicoline) Improves Retinal and Cortical Responses in Patients with Glaucoma. Ophthalmology. 106 (6): 1126-1134. 5.
[10]	Parisi V. (2005). Electrophysiological assessment of glaucomatous visual dysfunctionduring treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up. DocOphthalmol. 110 (1): 91-102.
[11]	Wright TM. (2006). Tramiprosate. Drugs Today (Barc). 42 (5): 291-8.
[12]	Caltagirone C, et al. (2012). The potential protective effect of tramiprosate (homotaurine) against Alzheimer's disease: a review. Aging Clin Exp Res. 24 (6): 580-7.
[13]	Spalletta G, et al. (2016). Homotaurine Effects on Hippocampal Volume Loss and Episodic Memory in Amnestic Mild Cognitive Impairment. J Alzheimers Dis. 50 (3): 807-16.
[14]	Nunes-Tavares N, et al. (2012). Inhibition of CholineAcetyltransferase as a Mechanism for Cholinergic Dysfunction Induced by Amyloid Peptide Oligomers. The Journal of Biological Chemistry. 287 (23): 19377-19385.
[15]	Wu S, et al. (2014). Tramiprosate protects neurons against ischemic stroke by disrupting the interaction between PSD95 and nNOS. Neuropharmacology. 83: 107-17.
[16]	Martorana A, et al. (2014). Homotaurine induces measurable changes of short latency afferent inhibition in a group of mild cognitive impairment individuals. Front Aging Neurosci. 6: 254.
[17]	Davinelli S, et al. (2017). Cytoprotective Effects of Citicoline and Homotaurine against Glutamate and High Glucose Neurotoxicity in Primary Cultured Retinal Cells. Oxid Med CellLongev. 2017: 2825703.
[18]	Ventura L. M., Porciatti V. (2006). Pattern Electroretinogram in Glaucoma. Curr Opinion Ophtalmol. 17 (2): 196-202.
[19]	Ventura L. M., Porciatti V. et al. (2005). Pattern Electroretinogram abnormality and Glaucoma. Ophalmology 112 (1): 10-9.
[20]	Turkey E, et al. (2019). Role of Pattern Electroretinogram in Ocular Hypertension and Early Glaucoma. J. Glaucoma vol. 28. 871-877.
[21]	Verdina T. et al. (2020). Association of Ultrapure Citicoline, Homotaurine and Vitamin E in the management of Normotensive Glaucoma: A Case Report. Ophtalmol. 11: 222-228.

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APA Style

Camillo Cornelio, Lorenzo Crisigiovanni, Virginia Limardo, Davide Nuzzo, Pasquale Troiano. (2021). Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. International Journal of Ophthalmology & Visual Science, 6(2), 75-79. https://doi.org/10.11648/j.ijovs.20210602.13

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ACS Style

Camillo Cornelio; Lorenzo Crisigiovanni; Virginia Limardo; Davide Nuzzo; Pasquale Troiano. Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. Int. J. Ophthalmol. Vis. Sci. 2021, 6(2), 75-79. doi: 10.11648/j.ijovs.20210602.13

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AMA Style

Camillo Cornelio, Lorenzo Crisigiovanni, Virginia Limardo, Davide Nuzzo, Pasquale Troiano. Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. Int J Ophthalmol Vis Sci. 2021;6(2):75-79. doi: 10.11648/j.ijovs.20210602.13

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@article{10.11648/j.ijovs.20210602.13,
  author = {Camillo Cornelio and Lorenzo Crisigiovanni and Virginia Limardo and Davide Nuzzo and Pasquale Troiano},
  title = {Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {2},
  pages = {75-79},
  doi = {10.11648/j.ijovs.20210602.13},
  url = {https://doi.org/10.11648/j.ijovs.20210602.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210602.13},
  abstract = {Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: - group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; - group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.},
 year = {2021}
}

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TY  - JOUR
T1  - Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination
AU  - Camillo Cornelio
AU  - Lorenzo Crisigiovanni
AU  - Virginia Limardo
AU  - Davide Nuzzo
AU  - Pasquale Troiano
Y1  - 2021/04/16
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210602.13
DO  - 10.11648/j.ijovs.20210602.13
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 75
EP  - 79
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210602.13
AB  - Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: - group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; - group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.
VL  - 6
IS  - 2
ER  -

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Author Information

Camillo Cornelio

Department of Ophthalmology, Sacred Family Fatebenefratelli Hospital, Erba, Italy
Lorenzo Crisigiovanni

Department of Ophthalmology, Sacred Family Fatebenefratelli Hospital, Erba, Italy
Virginia Limardo

Department of Ophthalmology, Sacred Family Fatebenefratelli Hospital, Erba, Italy
Davide Nuzzo

Department of Ophthalmology, Sacred Family Fatebenefratelli Hospital, Erba, Italy
Pasquale Troiano

Department of Ophthalmology, Sacred Family Fatebenefratelli Hospital, Erba, Italy

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Plain Text BibTeX RIS

APA Style

Camillo Cornelio, Lorenzo Crisigiovanni, Virginia Limardo, Davide Nuzzo, Pasquale Troiano. (2021). Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. International Journal of Ophthalmology & Visual Science, 6(2), 75-79. https://doi.org/10.11648/j.ijovs.20210602.13

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ACS Style

Camillo Cornelio; Lorenzo Crisigiovanni; Virginia Limardo; Davide Nuzzo; Pasquale Troiano. Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. Int. J. Ophthalmol. Vis. Sci. 2021, 6(2), 75-79. doi: 10.11648/j.ijovs.20210602.13

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AMA Style

Camillo Cornelio, Lorenzo Crisigiovanni, Virginia Limardo, Davide Nuzzo, Pasquale Troiano. Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination. Int J Ophthalmol Vis Sci. 2021;6(2):75-79. doi: 10.11648/j.ijovs.20210602.13

Copy | Download

@article{10.11648/j.ijovs.20210602.13,
  author = {Camillo Cornelio and Lorenzo Crisigiovanni and Virginia Limardo and Davide Nuzzo and Pasquale Troiano},
  title = {Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {6},
  number = {2},
  pages = {75-79},
  doi = {10.11648/j.ijovs.20210602.13},
  url = {https://doi.org/10.11648/j.ijovs.20210602.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210602.13},
  abstract = {Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: - group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; - group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.},
 year = {2021}
}

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TY  - JOUR
T1  - Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination
AU  - Camillo Cornelio
AU  - Lorenzo Crisigiovanni
AU  - Virginia Limardo
AU  - Davide Nuzzo
AU  - Pasquale Troiano
Y1  - 2021/04/16
PY  - 2021
N1  - https://doi.org/10.11648/j.ijovs.20210602.13
DO  - 10.11648/j.ijovs.20210602.13
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 75
EP  - 79
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20210602.13
AB  - Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: - group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; - group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.
VL  - 6
IS  - 2
ER  -

Copy | Download