Funding awarded for clinical trial of a vitamin treatment for glaucoma

A team led by Moorfields Eye Hospital consultant ophthalmologist Professor Ted Garway-Heath at the UCL Institute of Ophthalmology (IoO) has been awarded a £1.9 million grant for a major four-year clinical trial to test the effectiveness of nicotinamide (NAM), a form of vitamin B3, in a pill format as a treatment for glaucoma.  

Glaucoma is a common eye condition in which the optic nerve, which connects the eye to the brain, becomes damaged. The most important risk factors are high pressure in the eye and older age. It is the world’s most common cause of irreversible blindness and affects 1 in 50 people aged over 50, rising to 1 in 20 in people aged over 80.

Current treatment for glaucoma includes eye drops, laser treatment and surgery. These treatments aim to reduce pressure in the eye, thereby reducing damage to the optic nerve. Although glaucoma cannot be cured, current treatments can slow and sometimes halt its progression. However, many people’s condition worsens even with treatment, and some people develop glaucoma with normal eye pressure. Currently, doctors cannot identify who these people will be before treatment.

The new study will be based primarily at UCL IoO, as it has recently acquired a seahorse analyzer (with funding from Moorfields Eye Charity), a machine that allows scientists to look at mitochondrial function within cells the basis for much of this study.

The trial builds on collaborative research at Moorfields, UCL IoO and the UCL Queen Square Institute of Neurology (IoN) showing that patients with both high- and low-tension glaucoma have lower mitochondrial function than healthy patients; and that patients with ocular hypertension (higher than normal pressure inside the eye), but no signs of progression to glaucoma, have higher mitochondrial function.

Starting in August 2022, the trial will eventually recruit 496 glaucoma patients across seven UK sites, with a pilot study starting at Moorfields and Kings College Hospital in London along with a third site yet to be confirmed. If treatment with NAM proves successful, it could significantly reduce the damage to vision caused by glaucoma and the cost of treatment for the NHS.

Prof. Ted Garway-Heath, lead applicant for the grant, said: “We hope to find a treatment that isn’t directed at pressure in the eye, but that addresses the susceptibility of the patient to glaucoma. We also hope to identify a blood test to identify which patients will benefit from the new treatment.”

The trial has been funded by the National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation (EME) Programme. The programme funds ambitious studies that evaluate interventions that have the potential to make a significant change in the promotion of health, treatment of disease and improvement of rehabilitation or long-term care.

To find out about research going on at Moorfields and register your interest in participating, please visit

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