Nicotinamide Supplementation in Glaucoma

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• Patients with active liver disease or end stage renal failure.
  • Active use of allopurinol, carbamazepine, or primidone.
  • Visually significant cataracts (example, likely to require surgery within 2 years).
  • Cataract surgery in the last 3 months or glaucoma filtration surgery in last 6 months.
  • Conditions that may cause non-glaucomatous visual field defect (for example, severe ptosis, cerebrovascular accident, prior panretinal photocoagulation, and other retinal or central nervous system diseases).
  • Not able to complete study (for example, concurrent severe systemic disease).
  • History of cancer in the last 5 years.
  • Unable to give consent.
  • Inability to tolerate or take nicotinamide and/or pyruvate.
  • Women of Child Bearing Potential, pregnancy or lactation.
  • History of Hypotension
  • Blood Pressure measurement of less than 90/60(

• Patients aged ³ 21 years, with definitive, treated POAG, PACG including normal tension glaucoma, PDG, PXFG in one or both eyes.
  • Best-corrected visual acuity equal or better than 6/18
  • Reproducible visual field defect due to glaucoma (3 contiguous points at less than 5%) and severity of visual field loss, MD between -2 and -18 dB. This range includes people with moderate disease which optimises detection of progression.
  • Patients must have at least two prior 24-2 VF tests which meet <16% FP and <21% fixation loss.
  • Previous selective laser trabeculoplasty is acceptable (IOP-lowering laser treatment) if ³ 3 months prior or filtering surgery >6 months previously.
  • Normal liver function tests.
  • Those taking NAM already will undergo a 1-month washout period bef