In a recent preclinical trial at Karolinska Institute, investigators have uncovered hopeful evidence that vitamin supplementation might slow the progression of glaucoma by protecting the optic nerve. The findings, reported in Cell Reports, also is the first to give a clear indication of what goes wrong with the regulation of fluid (aqueous humor) pressure inside the eye that causes glaucoma. [1]

Preclinical Study Suggests Vitamin Supplementation Can Slow Glaucoma Progression

Interesting News . Sep 23, 2025

In a recent preclinical trial at Karolinska Institute, investigators have uncovered hopeful evidence that vitamin supplementation might slow the progression of glaucoma by protecting the optic nerve. The findings, reported in Cell Reports, also is the first to give a clear indication of what goes wrong with the regulation of fluid (aqueous humor) pressure inside the eye that causes glaucoma. [1]

Glaucoma is a family of eye diseases resulting in optic nerve damage, and if left untreated, can result in painless (which is characteristic) vision loss and even complete blindness. It is a leading cause of preventable blindness worldwide. Increased intraocular pressure (IOP) is the main risk for glaucoma, although glaucomatous destruction of the optic nerve can also occur in individuals with a normal eye pressure. The treatment of glaucoma is based on reducing the eye pressure through medications, lasers or surgery to a new lower, desirable level. However, not all patients benefit from therapy to prevent progression of the glaucoma. Therefore, researchers seek to evaluate the potential for additional therapeutic options. [2]

Homocysteine and Glaucoma: A Re-evaluation

The Traditional View

Historically, glaucoma has been thought to be driven by an amino acid called homocysteine. High levels of homocysteine are associated with cardiovascular diseases, and it was suspected that elevated levels would contribute to the damage to the optic nerve in glaucoma patients.

Challenging the Theory

Recent work from the Karolinska Institute has challenged this view. When homocysteine was raised in rats in a series of experiments, the high levels of homocysteine did not adversely affect the progression of glaucoma, or optic nerve damage, calling into question the role of homocysteine in the progression of disease.

The absence of a link to glaucoma

Again, this study returned negative results regarding hyperhomocysteinemia and an increased incidence of glaucoma in these genetically predisposed individuals (with findings suggesting that homocysteine might not be more heavily involved in glaucoma etiology). [3]

New Hypothesis: Retinal Metabolic Dysfunction

According to the researchers, changes in the concentration of homocysteine reflects metabolic dysfunction in the retina rather than the root cause of glaucoma. It’s possible that the retinal tissue does not appropriately metabolize certain key vitamins to contribute to the advancement of this disease.

Shift of Focus

This new perspective clearly shifts the focus from homocysteine to retinal health and vitamin metabolism, and paying closer attention to metabolic dysfunction of the retina could yield additional potential insights and therapeutic approaches for glaucoma. [4]

Vitamin Supplementation as a Protective Mechanism

Research Hypothesis and Focus:

The aim of the researchers was to see if the supplementation of vitamins from diet could protect the retina from damage by glaucoma.
They hypothesized that a certain group of vitamins, important for retinal metabolism, might slow the progression of the disease or might even stop further damage to the optic nerve.

Key Vitamins Studied:

The vitamins that were studied 6 were B6, B9 and B12 as well as choline.

These vitamins are decisive for:

Cell metabolism: decisive for energy production and the operation of retinal cells.
Neurotransmitter synthesis: Assist in refreshing how retinal cells Method information.
Extra nutrients: Assist in fighting oxidative stress associated with retinal degeneration.

These vitamins are linked to homocysteine metabolism potentially influencing retinal vascularity

Preclinical Study Results:

In preclinical studies conducted on rodents researchers administered vitamin supplements to animals with induced glaucoma.

Mice Results:

Mice that received vitamin B6 B9 B12 and choline supplements exhibited very importantly slower disease progression compared to untreated mice.
In some cases, damage to the optic nerve was extremely halted.
The vitamins improved retinal metabolism restored normal cellular function and reduced oxidative stress factors that contribute to retinal degeneration in glaucoma.

Rats Results:

In rats with a more aggressive form of glaucoma where the disease progressed at a faster rate vitamin supplementation also slowed the progression.
This finding is specifically significant because faster-progressing forms of glaucoma are more challenging to treat with existing therapies.

Important Takeaway:

The benefits of vitamin supplementation were observed independently of treatments aimed at lowering intraocular pressure (IOP).

This suggests that vitamins may provide an additional complementary therapeutic mechanism that does not rely on reducing IOP but instead focuses on protecting retinal health and the optic nerve. [5] [6]

Table: Key Vitamins and Their Role in Glaucoma Treatment

Vitamin/Compound	Functions	Preclinical Effects in Glaucoma
Vitamin B6 (Pyridoxine)	Vital for neurotransmitter synthesis, cellular metabolism	Slowed disease progression, improved retinal metabolism, reduced oxidative stress
Vitamin B9 (Folate)	Crucial for DNA synthesis, cell function, and growth	Slowed disease progression, improved retinal health
Vitamin B12 (Cobalamin)	Essential for nerve function, DNA synthesis, and metabolic processes	Slowed disease progression, protected optic nerve
Choline	Involved in neurotransmitter synthesis, cellular signaling	Improved retinal metabolism, reduced oxidative stress

Moving Towards Clinical Trials

Promising Preclinical Findings:

The preclinical studies yielded such positive results that the researchers decided to initiate a clinical trial to Check the efficacy of vitamin supplementation in glaucoma patients.
The goal of the trial is to determine if the vitamin supplementation can replicate the protective effects observed in animal Representations specifically in slowing disease progression and protecting the optic nerve.

Clinical Trial Details:

The clinical trial is being conducted at St. Eriks Eye Hospital in Stockholm.

The trial raise patients with cardinal types of glaucoma:

Open-angle glaucoma: A slower-progressing form of the disease.
Pseudoexfoliation glaucoma: A more severe type of glaucoma that advances very quickly.

The main objective is to test whether vitamin supplementation can slow the progression of these forms of glaucoma and protect the optic nerve in human patients, like what was observed in animal studies. [7]

Trial Rules and Assessment:

The clinical trial will be performed under a firm protocol so that careful examination of the influence of vitamin supplementation is gained.

Critical actions are:

Good health of the retina: The good health of the retina throughout the trial.
Damage to the optic nerve: Examination of the protective effects on the optic nerve that may reduce harm due to glaucoma.
Visual function: Examine the changes in visual acuity and general visual Effectiveness.

Researchers will also observe biomarkers of retinal metabolic and oxidative stress that were difficult parameters in the preclinical study.

Potential Impact of the Trial:

If the clinical trial verifies the preclinical results vitamin supplementation may become a significant adjunctive treatment for patients with glaucoma.

Vitamin supplementation offers a low-risk and cost-effective option that could potentially slow down disease progression and protect the optic nerve improving the quality of life for patients living with glaucoma. [1] [8]

Table: Clinical Trial Protocol and Objectives

Parameter	Details
Study Location	St. Eriks Eye Hospital, Stockholm
Types of Glaucoma Studied	Open-angle glaucoma, Pseudoexfoliation glaucoma
Objective	Evaluate the effect of vitamin supplementation on disease progression and optic nerve protection
Key Assessments	Retinal health, visual function, optic nerve damage, biomarkers for retinal metabolism and oxidative stress
Primary Endpoint	Slowing disease progression and protecting optic nerve
Expected Outcome	Confirm if vitamin supplementation can replicate preclinical findings in humans

Potential Mechanisms of Action

The exact mechanism by which vitamin supplementation protects the optic nerve and slows glaucoma progression is still under investigation. Nonetheless various potential mechanisms have emerged from the study:

Retinal Metamorphosis Restoration: Vitamins B6 B9 B12 and choline are difficult for retinene metamorphosis. In glaucoma impaired metabolism can cause cellular dysfunction. Supplementing these vitamins get mend metabolic processes and protect retinal cells from damage
Oxidative Strain Reduction: Glaucoma leads to increased oxidative stress, accelerating retinal cell death. The vitamins examined have antioxidant effects potentially lowering oxidative damage and defending against retinal cells and the optic nerve.
Homocysteine Regulation: Although homocysteine itself is not the direct cause of glaucoma these vitamins assist with the regulation of its level. By increasing homocysteine metabolism, the vitamins can relieve secondary effects that aggravate retinal damage. [9]

Implications for Glaucoma Treatment

If confirmed by clinical trials vitamin supplementation could change glaucoma treatment by offering a dual approach: targeting both intraocular pressure (IOP) and retinal health. It could benefit patients who do not respond good to conventional therapies. Vitamin supplementation is a low-cost, non-invasive intervention with few side effects and thus an appealing alternative for the long-term management of glaucoma. If found to be effective it has the potential to become an accepted addition to existing treatments.

Conclusion

Karolinska Institute’s preclinical study offers a promising new avenue for glaucoma treatment. This open potential treatment avenues besides IOP reduction strategies. The ability to supplement vitamins to slow down disease progression and protect the optic nerve is proven. The ongoing clinical trial will determine if these results can be replicated in humans potentially transforming glaucoma care. If successful, vitamin supplementation could provide a safe, accessible alternative to existing treatments, offering hope for better outcomes for glaucoma patients globally.

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