PURPOSE: to investigate the long-term effects on visual field of cytidin-5’-diphosphocholine (citicoline)
METHODS: a 10 year-follow-up perspective study was performed on 23 glaucomatous patients. 11 patients were treated with intramuscular citicoline (1g daily per 15 days repeated every 6 months) while 12 patients were untreated. All the patients had pharmacologically compensated IOP. The value considered for statistical analysis was the non-perception area (NPA), a perimetric index obtained by means of a computerized Video-screen technique commonly used in our department. A preliminary correlation test (Pearson’s test) between NPA and MD index of conventional automated perimetry (Humphrey perimeter) was peformed. ANOVA for repeated measures and survival analysis (Log-rank test) were applied for statistical purposes.
RESULTS: As resulting from the correlation test, NPA can be considered an indirect measure of retinal sensitivity, being strictly correlated to MD (Pearson’s R=0.9). The groups were homogeneous in age, mean IOP, gender and stage of visual field defects. The citicoline treated group showed a significant reduction of NPA at 1 year control (P<0.0001). The NPA remained stable for the subsequent 9 years. In the control group a progressive visual field deterioration was evidenced as revealed by the increase of NPA. The Log-rank test pointed out that visual field deterioration is statistically more frequent in citicoline-untreated patients (P=0.025).
CONCLUSIONS: Intramuscularly citicoline seems to prevent visual field defects progression in glaucomatous patients