Recent research has suggested a possible neuroprotective role for Vitamin B3 (nicotinamide) in glaucoma, but clinical evidence is still preliminary. The interest in nicotinamide stems from its role as a precursor to NAD⁺, a molecule essential for mitochondrial function and cellular energy metabolism. In animal models, particularly in mice predisposed to glaucoma, nicotinamide supplementation was shown to protect retinal ganglion cells and preserve optic nerve function (Williams et al., Science, 2017). These findings generated interest in its potential application in human glaucoma, a disease characterized by progressive optic nerve damage.

Early-stage clinical studies in humans have produced encouraging, but not definitive, results. For example, a small 2020 pilot trial found that high-dose nicotinamide improved inner retinal function in patients with glaucoma, as measured by electroretinography. However, these studies are limited by small sample sizes, short durations, and lack of long-term outcome data.

In summary, while nicotinamide is not a traditional therapy for glaucoma, and it is not included in standard management guidelines, there is emerging preclinical and limited clinical evidence suggesting a potential benefit. Larger, long-term clinical trials are needed to establish efficacy and safety for this indication.