5 Key Takeaways

• 1

  Derek S. Welsbie reviewed nicotinamide and GLP-1 receptor agonists as potential metabolic approaches to optic nerve neuroprotection at AAO 2026.

• 2

  Preclinical studies suggest nicotinamide can raise NAD levels and prevent glaucomatous damage in mice, while early human studies reported possible functional improvements.

• 3

  Evidence that nicotinamide slows glaucoma progression remains unconvincing, and high-dose supplementation has been associated with hepatotoxicity.

• 4

  Observational studies have linked GLP-1 receptor agonist use with lower glaucoma rates, but they cannot establish causality or show protection against progression in established glaucoma.

• 5

  Welsbie does not routinely recommend either treatment and said randomized controlled trials are needed to assess their efficacy and safety.