Nicotinamide (vitamin B3) has gained scientific interest as a potential neuroprotective agent in the management of glaucoma, a disease characterized by progressive optic nerve degeneration. Preclinical studies, particularly in mouse models of glaucoma, have demonstrated that nicotinamide supplementation can protect retinal ganglion cells from degeneration and preserve visual function. For instance, a landmark study published in "Science" in 2017 showed that high-dose nicotinamide prevented the development of glaucoma in aged mice by supporting mitochondrial function and cellular energy metabolism in retinal ganglion cells.

In humans, emerging clinical research has provided preliminary support for nicotinamide’s role. A 2020 randomized, double-blind, crossover clinical trial ("Clinical and Experimental Ophthalmology") showed that high-dose nicotinamide supplementation improved inner retinal function (as measured by photopic negative response) in patients with glaucoma over 12 weeks. However, evidence is still limited by small sample sizes, short durations, and a lack of long-term outcome data. No major guidelines currently recommend nicotinamide as a standard treatment for glaucoma, but ongoing trials continue to investigate its utility as an adjunct to intraocular pressure-lowering therapies.

In summary, nicotinamide’s use for glaucoma is supported by promising animal data and initial human studies, warranting further research but not routine clinical use at this time.