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. 2023 Sep 28;18(9):e0291836.
doi: 10.1371/journal.pone.0291836. eCollection 2023.

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

Julia Prinz  1   2 , Verena Prokosch  2 , Hanhan Liu  2 , Peter Walter  1 , Matthias Fuest  1 , Filippo Migliorini  3   4
Affiliations

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

Julia Prinz et al. PLoS One. .

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: There is a lack of sufficient evidence to support that citicoline slows the progression of glaucoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the literature search.
Fig 2
Fig 2. Risk of bias graph for randomized controlled studies.
See this image and copyright information in PMC

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