Effect of Fixed Combination Citicoline Homotaurine and Pyrroloquinoline Quinone on Pattern-electroretinogram in Glaucoma

Inclusion Criteria:

• age > 18 years;

• diagnosis of primary OAG (POAG) from, at least, 3 years;

• visual acuity > 0.7 (7/10) decimals;

• refractive error < 5 Diopter (D) (spheric) and < 2D (toric);

• transparent diopter means (cornea and lens);

• controlled intraocular pressure (IOP) (<18 mmHg, morning value) with prostaglandinanalogues as monotherapy;

• stable intraocular pressure - IOP < 18 mmHg in the last 2 years;

• stable and unchanged topical therapy in the last 6 months;

• at least two reliable visual fields (Humphrey 24-2 Swedish interactive thresholdalgorithm-SITA Standard) per year in the last 2 years;

• early to moderate visual field defect (mean deviation, MD <12 dB);

• electrophysiological (pattern electroretinogram-PERG) parameters alterations similarto glaucomatous pathology;

• written consent to participate to study procedures and data utilization in ananonymous form

Exclusion Criteria:

• ocular hypertension with normal optic nerve and visual field; angle closureglaucoma; congenital glaucoma; secondary glaucoma; normal tension glaucoma;

• history of recurrent uveitis/scleritis/herpes infection;

• pregnancy and breastfeeding;

• contraindication to Citicoline and/or Homotaurine and/or pyrroloquinoline quinone -PQQ

• contraindication to prostaglandine analogues

• topical therapy with Brimonidine or beta-blockers as monotherapy or fixedcombination

• topical therapy with pilocarpine and aceclidine, monotherapy or fixed combination

• systemic or topical treatment with another neuroprotective agent in the last 4months prior to enrollment

• systemic betablockers

• systemic therapies affecting patients' performance in visual field examination (sedatives);

• glaucomatous scotomas within 10 degree from fixation

• any condition limiting the patient's ability to participate in the study;

• other ocular causes of visual field and PERG changes, such as cataract, myopicchorioretinopathy, macular diseases, retinal vascular occlusion, diabeticretinopathy;

• other systemic causes of visual field and PERG changes such as neurodegenerativedisorders (Alzheimer's disease, Parkinson's disease, acute lateral sclerosis,multiple sclerosis) or pituitary disorders;

• cerebral ischemia in the last 2 years

• any change in topical therapy in the 6 months prior to enrollment or during thestudy period

• concomitant participation to another clinical trial

• any previous filtering and/or retinal surgery;

• cataract surgery in the last 6 months;

• any previous laser treatment for glaucoma in the last 5 years