A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and…

Randomized trialInvestigative ophthalmology & visual science· Jul 2026

A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and Pyruvate for Open-Angle Glaucoma.

C Gustavo De Moraes, Aakriti G Shukla, George A Cioffi … Jeffrey M Liebmann

GlaucomaRandomized trialTreatmentQ1IF 4.2

Nicotinamide plus pyruvate increased odds of localized visual field improvement in glaucoma

A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and Pyruvate for Open-Angle Glaucoma.

C Gustavo De Moraes … Jeffrey M Liebmann

Investigative ophthalmology & visual science · Jul 2026 · Q1 in Ophthalmology

Purpose

The purpose of this study was to characterize topographical visual field (visual field) improvement using pointwise total deviation (total deviation) slopes referenced to baseline severity, and to evaluate structure-function and cognitive associations in eyes receiving nicotinamide and pyruvate (NAM + PYR) treatment versus placebo.

Methods

This post hoc analysis used study-eye data from a phase 2 randomized trial of nicotinamide (3 g/day) plus pyruvate (3 g/day) versus placebo in open-angle glaucoma, with four baseline and four post-baseline visual field visits.

Results

treated eyes were nearly 4 times more likely to show improved vision than untreated eyes

OR 3.73 (95% CI 2.36 to 5.89)

CI excludes the null - significant

More results

Improvement clustered along arcuate pathways and within moderate-to-deep baseline damage.

The Bayesian model estimated a 98.4% posterior probability that NAM + PYR treatment increased improving locations; retinal nerve fiber layer priors corroborated modestly but did not materially refine inference.

More results

No association was found with Montreal Cognitive Assessment scores.

“

Conclusion · 1 of 2

Topographical, slope-based endpoints reveal localized arcuate visual field improvement with nicotinamide and pyruvate that is missed by global indices and not explained by cognitive change.

Conclusion · 2 of 2

Bayesian modeling suits small early-phase neuroprotection trials, although structural priors added little over this short follow-up.

A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and Pyruvate for Open-Angle Glaucoma.

A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and Pyruvate for Open-Angle Glaucoma.

Related papers