A recent study showing vitamin B3 can prevent glaucoma in mice should inspire researchers to test the idea in clinical trials, write two Columbia University ophthalmologists in a commentary published in the May 25th issue of the New England Journal of Medicine.

“This is a new potential treatment pathway for glaucoma,” says Jeffrey Liebmann, MD, who wrote the commentary with George Cioffi, MD, chair of ophthalmology. “Right now, we can slow the progression of the disease by reducing pressure inside the eye with drugs or surgery, but we can’t halt the disease in many patients. Our ultimate goal is to find a treatment that can prevent the degeneration of neurons that cause vision loss.”

Glaucoma is the leading cause of irreversible blindness and affects more than 70 million people worldwide. The need for neuron–sparing therapies has become even more acute as people live longer. “People used to have glaucoma for 15 years,” says Dr. Liebmann. “Now, with increasing longevity and duration of disease exposure, the lifetime risk of visual disability is increasing.

Although several drugs have been tested previously in clinical trials, none have received FDA approval to protect neurons in glaucoma patients.

In the new study, researchers identified how neurons begin degenerating in glaucoma, and demonstrated that nicatinamide (a form of Vitamin B3) could prevent the neurodegeneration. Nicatinamide supplements were able to prevent glaucoma in 70 percent of mice predisposed to the disease. Adding a gene therapy to increase nicatinamide protected even more mice.

Drs. Liebmann and Cioffi are now beginning preliminary studies in preparation for a human clinical trial of nicatinamide.