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NAD+ and Niacin Supplementation as Possible Treatments for Glaucoma and Age-Related Macular Degeneration: A Narrative Review.

  • 2024-08-21
  • Nutrients 16(16)
    • Mohamed R Gemae
    • Mario D Bassi
    • Patrick Wang
    • Eric K Chin
    • David R P Almeida

Study Design

Type
Review
Methods
Literature search encompassing keywords such as "niacin", "NAD", "glaucoma", "AMD", and "therapeutics"
  • Rigorous Journal
Glaucoma and age-related macular degeneration (AMD) are progressive retinal diseases characterized by increased oxidative stress, inflammation, and mitochondrial dysfunction. This review investigates the potential therapeutic benefits of NAD+ and niacin supplementation in managing glaucoma and AMD. A literature search was conducted encompassing keywords such as "niacin", "NAD", "glaucoma", "AMD", and "therapeutics". NAD+ depletion is associated with increased oxidative stress and mitochondrial dysfunction in glaucoma and AMD. Niacin, a precursor to NAD+, has shown promise in replenishing NAD+ levels, improving choroidal blood flow, and reducing oxidative damage. Animal studies in glaucoma models indicate that nicotinamide (NAM) supplementation preserves RGC density and function. Large-scale population-based studies indicate an inverse correlation between niacin intake and glaucoma prevalence, suggesting a preventative role. Randomized controlled trials assessing niacin supplementation showed significant improvements in visual field sensitivity and inner retinal function, with a dose-dependent relationship. In AMD, nicotinamide supplementation may improve rod cell function and protect against oxidative stress-induced damage. Cross-sectional studies reveal that individuals with AMD have a lower dietary intake of niacin. Further studies suggest niacin's role in improving choroidal blood flow and dilating retinal arterioles, potentially mitigating ischemic damage and oxidative stress in AMD. Beyond current management strategies, NAD+ and niacin supplementation may offer novel therapeutic avenues for glaucoma and AMD. Further research is warranted to elucidate their efficacy and safety in clinical settings.

Research Insights

  • Vitamin B3→Improved Inner Retinal Function

    Randomized controlled trials assessing niacin supplementation showed significant improvements in visual field sensitivity and inner retinal function, with a dose-dependent relationship.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B3→Improved Visual Field Sensitivity

    Randomized controlled trials assessing niacin supplementation showed significant improvements in visual field sensitivity and inner retinal function, with a dose-dependent relationship.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B3→Reduced Age-Related Macular Degeneration Prevalence

    Cross-sectional studies reveal that individuals with AMD have a lower dietary intake of niacin.

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin B3→Reduced Glaucoma Prevalence

    Large-scale population-based studies indicate an inverse correlation between niacin intake and glaucoma prevalence, suggesting a preventative role.

    Effect
    Beneficial
    Effect size
    Large

Adverse Events Reported

  • Vitamin B3→Overall tolerability

    Further research is warranted to elucidate their efficacy and safety in clinical settings.

    Finding
    Reported
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