Impact of Oral Citicoline, Antioxidant Vitamins, and Blackcurrant Supplementation on Primary Open-Angle Glaucoma: An OCT and OCTA Study

<b>Purpose:</b> We sought to evaluate the long-term effects of oral citicoline; vitamins A, B, C, and E; and blackcurrant therapy in patients with primary open-angle glaucoma (POAG) using optical coherence tomography (OCT), OCT angiography (OCTA), and microperimetry parameters. <b>Materials and Methods:</b> Fifteen patients with POAG (the treated group) received one soluble liquid sachet of a complementary dietary supplement containing, in a fixed combination, citicoline; vitamins A, B, C, and E; and blackcurrant (Citizin^®, Bruschettini s.r.l., Genova, Italy) daily for 20 days a month for 1 year. Fifteen age-matched patients with POAG were given a placebo and served as a control group. The patients underwent best-corrected visual acuity (BCVA) analysis, Goldmann applanation tonometry, microperimetry examination, OCT, and OCTA at the beginning of the study and then 1, 6, and 12 months later. <b>Results:</b> A significant improvement in the overall retinal nerve fiber layer (RNFL) thickness values (compared with the control group) was recorded at the 6- (<i>p</i> < 0.009) and 12 (<i>p</i> < 0.001)-month follow-ups in the treated group. The ganglion cell complex (GCC) increased in thickness (compared with the control group) at the 12-month follow-up (<i>p</i> < 0.0001) in the treated group. The mean macular vessel density (MVD) and the mean peripapillary vessel density (PVD) in the treated group were significantly higher than those in the control group at the 12-month follow-up. Microperimetry examination, BCVA, and Goldmann applanation tonometry showed no statistically significant alterations. <b>Conclusions:</b> A fixed combination of citicoline; vitamins A, B, C, and E; and blackcurrant administered orally may have a positive impact on RNFL, GCC, MVD, and PVD in patients with POAG.