{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:06:55Z","timestamp":1793192815006,"version":"4.5.0"},"reference-count":32,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hanlim Pharma","award":["Not applicable, as this is an industrial funding."],"award-info":[{"award-number":["Not applicable, as this is an industrial funding."]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,10,12]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>The neuroprotective effect of nicotinamide (NAM) supplementation has been demonstrated in both animal models and clinical trials. We conducted a trial to assess whether oral NAM improves retinal function in normal-tension glaucoma (NTG) participants receiving intraocular pressure (IOP)-lowering therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-three NTG participants (untreated IOP \u226418\u2009mm Hg) were enrolled in a double-masked, placebo-controlled crossover randomised clinical trial. Participants were randomly assigned to receive either oral placebo or NAM, followed by crossover without a washout period. Each treatment was administered for 12 weeks (NAM\/placebo 1 g\/day for 6 weeks, then 2 g\/day for the subsequent 6 weeks). Retinal function was evaluated using full-field electroretinography and visual field testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 12 weeks, the amplitude changes of the photopic negative response in peak-to-trough (PhNRPT) and the B-wave were significantly greater in the NAM group (3.121\u00b13.968\u2009and 2.112\u00b13.220 \u03bcV, respectively) compared with the placebo group (0.996\u00b14.190\u2009and 0.305\u00b13.279 \u03bcV, respectively; p=0.045\u2009and p=0.032). PhNRPT improved beyond twice the 95% coefficient of variation in 29.0% of the NAM group and 19.3% of the placebo group. No significant intergroup differences were observed in changes in mean deviation, pattern SD or visual field index after 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oral NAM supplementation in NTG participants induced functional improvement, as measured by PhNRPT and B-wave amplitude. Given that NTG is characterised by lower IOP, which may show a weaker correlation with electrophysiological activity and a slower progression rate compared with high-tension glaucoma, further long-term studies are needed to clarify the effects of NAM in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06078605\">NCT06078605<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328096","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:20:24Z","timestamp":1761844824000},"page":"417-424","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Effects of nicotinamide supplementation in normal-tension glaucoma: a crossover placebo-controlled randomised clinical trial"],"prefix":"10.1136","volume":"110","clinical-trial-number":[{"clinical-trial-number":"nct06078605","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06078605","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Ahnul","family":"Ha","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jeju University Hospital, Jeju University, Jeju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Kook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3791-0089","authenticated-orcid":false,"given":"Young In","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunsol","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myungjin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of 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