Trial reportInvestigative ophthalmology & visual science2026
A Topographical Analysis of Visual Field Improvement in a Phase 2 Randomized Trial of Nicotinamide and Pyruvate for Open-Angle Glaucoma.
Trial report in Investigative ophthalmology & visual science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The purpose of this study was to characterize topographical visual field (VF) improvement using pointwise total deviation (TD) slopes referenced to baseline severity, and to evaluate structure-function and cognitive associations in eyes receiving nicotinamide and pyruvate (NAM + PYR) treatment versus placebo. Methods: This post hoc analysis used study-eye data from a phase 2 randomized trial of nicotinamide (3 g/day) plus pyruvate (3 g/day) versus placebo in open-angle glaucoma, with four baseline and four post-baseline VF visits. A location was improving if its Huber robust pointwise TD slope ranked in the upper decile (≥90th percentile) of the pooled slope distribution within its baseline-severity stratum. Bayesian hierarchical models assessed treatment effects, incorporating optical coherence tomography retinal nerve fiber layer (RNFL) slopes as structural priors; Montreal Cognitive Assessment (MoCA) scores tested for cognitive confounding. Results: Thirty-two study eyes (21 receiving NAM + PYR, and 11 placebo) were analyzed. NAM + PYR treated eyes showed increased identification of improving locations versus placebo (Cochran-Mantel-Haenszel pooled odds ratio (OR) = 3.73, 95% confidence interval (CI) = 2.36-5.89, P < 0.001); a TD-difference sensitivity analysis was concordant (OR = 5.08, 95% CI = 1.22-21.17, P = 0.021). Improvement clustered along arcuate pathways and within moderate-to-deep baseline damage. The Bayesian model estimated a 98.4% posterior probability that NAM + PYR treatment increased improving locations; RNFL priors corroborated modestly but did not materially refine inference. No association was found with MoCA scores. Conclusions: Topographical, slope-based endpoints reveal localized arcuate VF improvement with nicotinamide and pyruvate that is missed by global indices and not explained by cognitive change. Bayesian modeling suits small early-phase neuroprotection trials, although structural priors added little over this short follow-up.
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