Effects of Citicoline in Multi-Component Combination on the Optic Nerve

The optic nerve is a “high-speed cable” formed by the convergence of more than one million retinal ganglion cell (RGC) axons; its integrity directly determines visual quality. Under the combined assault of elevated intraocular pressure, oxidative stress, and microcirculatory impairment, RGCs undergo continuous apoptosis and their axons gradually degenerate, ultimately leading to irreversible visual-field loss.

Traditional therapy focuses solely on lowering intraocular pressure, yet clinical observations show that 30–50 % of patients continue to progress even when pressure is controlled below the “safety” threshold. Consequently, the search for a neuro-vascular dual-protection strategy has become a new priority in glaucoma research.

New clinical evidence

A recent randomized controlled study published in *Biomedicines* provides fresh clinical support for “multi-target intervention.” Fifteen patients with primary open-angle glaucoma were enrolled in the treatment arm; while continuing latanoprost monotherapy for intraocular-pressure reduction, they received an oral compound containing citicoline, vitamins A/B/C/E, and blackcurrant extract.

The regimen was 20 days on, 10 days off each month, repeated for 12 months. Fifteen age-matched patients received an identical-appearing placebo. Using optical coherence tomography (OCT) and OCT angiography (OCTA), the team precisely tracked structural and microvascular changes in the optic nerve.

Study results

At six months, the treatment group already exhibited a significant increase in peripapillary retinal nerve fiber layer (RNFL) thickness; by 12 months this thickening had become even more pronounced, whereas RNFL thickness in the control group continued to decline. Ganglion cell complex (GCC) thickness in the macula also increased significantly in the treatment group at 12 months, indicating that both RGC somata and axons benefited simultaneously.

Synergistic effects of the three components

Mechanistically, citicoline—an endogenous phospholipid precursor—repairs damaged cell membranes, inhibits glutamate excitotoxicity, and boosts neurotransmitter levels. Vitamins A, C, E and the B-complex act synergistically to scavenge free radicals and maintain mitochondrial function, while blackcurrant, rich in anthocyanins, up-regulates nitric-oxide synthase, dilates vessels, and blocks inflammatory cascades. The combined “membrane-stabilizing, antioxidant, and perfusion-promoting” synergy of these agents may be the principal driver of the observed structural improvements.

Although microperimetry has not yet detected functional gains, the investigators attribute this to the follow-up duration and the scope of testing; longer-term, larger-scale studies are underway. Overall, the research opens a new door for a combined “neuroprotection + vasoprotection” strategy.

Reference

[1] Giunta P, D’Andrea L, Rinaldi M, et al. Impact of Oral Citicoline, Antioxidant Vitamins, and Blackcurrant Supplementation on Primary Open-Angle Glaucoma: An OCT and OCTA Study. *Biomedicines*, 2025, 13(6): 1352.

*Special note - This article is for informational purposes only and cannot replace a doctor's treatment diagnosis and advice. It should not be regarded as a recommendation or proof of efficacy of the medical products involved. If it involves disease diagnosis, treatment, and rehabilitation, please be sure to go to a professional medical institution to seek professional advice.

by GSHWORLD

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