Comparison of the Effect of 1000mg and 500mg Oral Citicoline on Visual Field and Ganglion Cell Layer Thickness in Primary Open Angle Glaucoma

Purpose: To compare the effects of 1000 mg and 500 mg oral citicoline on the visual field, retinal nerve fiber layer and ganglion cells layer thickness in well controlled primary open angle glaucoma. Methods: A double blind randomized controlled trial was conducted on 50 subjects (75 eyes). The randomization divided the subjects into two groups, the 1000 mg group and the 500 mg group. The evaluations were performed after 30 days and 60 days intervention by assessing Mean Deviation (MD) and Pattern Standard Deviation (PSD) of Humphrey Visual field as well as retinal nerve fiber layer (RNFL) and Ganglion Cell-Inner Plexiform Layer (GCIPL) on ocular imaging. Results: After 60 days, there was no significant difference between both groups in the MD, PSD, RNFL, and GCIPL values. The median MD increased in the 1000 mg group from -9.96 dB at baseline to -5.0 dB after 60 days and from the intragroup analysis, there was a significant difference (p=0.008). Based on subgroup analysis, there was also significant difference before and after the intervention in the mild glaucoma receiving 500 mg citicoline and in moderate-severe glaucoma receiving 1000 mg citicoline. RNFL and GCIPL thickness in both groups were tended to be stable. A side effect of nausea was found in two subjects who each received a dose of 500 mg and 1000 mg citicoline. Conclusion: There was an improvement in the MD and PSD values in both groups after 60 days of oral citicoline administration, but a significant difference was found in mild glaucoma group receiving 500 mg citicoline and in moderate-severe glaucoma receiving 1000 mg citicoline. The thickness of RNFL and GCIPL in both groups did not decrease after 60 days of citicoline administration.