Glaucoma TherapyNCT07567651
Citicoline and Filtration Surgery
A study testing Citicoline in people with Glaucoma Therapy, run by Fondazione IRCCS Policlinico San Matteo di Pavia at 1 site in Italy.
Trial summary
Glaucoma is a group of conditions characterised by a progressive loss of retinal ganglion cells (RGCs) and their axons, leading to characteristic changes in the optic nerve head and the retinal nerve fibre layer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Glaucoma Therapy
- What is being tested?
- Citicoline
- Type of treatment
- Pill or oral medicine, Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 6 participants
- Where
- 1 siteItaly
- Study dates
- 10 Aug 2021to 31 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- age > 18 years
- Ability to understand the protocol and provide informed consent to participate in the study
- Diagnosis of primary or secondary open-angle glaucoma (PEX - PIG) and the need to undergo subconjunctival filtration surgery due to signs of morphological/functional progression of the condition or failure to achieve target pressure with medical or pre-surgical therapy.
- The diagnosis of glaucoma is defined by the presence of typical ophthalmoscopic damage to the optic nerve head and the consequent visual field defect. In particular, a glaucomatous visual field defect will be considered as such if there is a cluster of 3 or more contiguous points in the pattern deviation plot with a probability of occurrence in the normal population of less than 5%, one of which has a probability of less than 1%, a pattern standard deviation with a probability of less than 5%, or a GHT result outside the normal limits.
- Early to moderate visual field defect, according to the Hodapp-Parrish-Anderson classification, i.e. with MD up to -12 dB, as determined by the Humphrey 24-2 SITA Standard computerised test.
- Rate of visual field defect progression > 0.5 dB/year, in the 2 years prior to surgery.
- At least 3 visual field examinations performed using standard perimetry in the 2 years prior to surgery.
Who cannot join
- Diagnosis of angle-closure glaucoma
- Previous glaucoma surgery (trabeculectomy, valve implantation or placement of other devices, cyclophotocoagulation)
- Previous vitreoretinal or corneal eye surgery
- Visual, neurological or general medical conditions that may affect the visual field, electrophysiological tests, OCT or A-OCT scans
- Systemic administration (oral or parenteral) of cerebral vasoactive drugs, neurotrophic agents, lutein, zeaxanthin, docosahexaenoic acid, ubiquinone and/or its derivatives, citicoline and/or its derivatives within 6 months prior to enrolment in the study
- Topical therapy with citicoline and/or its derivatives within 6 months prior to enrolment in the study
- Known or suspected allergy or sensitisation to the study product
- Pregnancy or breastfeeding
Trial locations and contacts
1 site in 1 country.
Italy1 site
Fondazione IRCCS Policlinico San Matteo di Pavia
Pavia, Lombardy, 27100
About this study
Official title: A Single-centre, Randomised, Double-blind Study to Assess the Efficacy of Citicoline Compared With Placebo on Visual Function in Glaucoma Patients Undergoing Subconjunctival Filtering Surgery for Glaucoma
Glaucoma is a group of conditions characterised by a progressive loss of retinal ganglion cells (RGCs) and their axons, leading to characteristic changes in the optic nerve head and the retinal nerve fibre layer. If left untreated, the disease has a natural course that can lead to progressive and significant impairment of visual function. Intraocular pressure (IOP) is the main modifiable risk factor for the onset and progression of the disease. The positive effect of surgery on the progression of glaucoma is certainly due to the reduction in IOP levels achieved in the post-operative period, with probable secondary effects on ocular haemodynamics as well. Although IOP reduction is now considered the most potent neuroprotective treatment for glaucoma, it has been shown that good tonometric control may, in some cases, not be sufficient to preserve visual function. There are, in fact, pressure-independent mechanisms involved in the pathogenesis of glaucomatous damage, in which the progressive deterioration and apoptosis of RGCs are linked to mechanisms such as oxidative stress, glutamate neurotoxicity, the inhibition of anterograde transport of neurotrophic factors, and mitochondrial dysfunction. In recent years, various molecules, including cytidine-5'-diphosphocholine (citicoline), have been proposed in combination with hypotensive therapy due to their neuroprotective and neuroenhancing effects. In addition to its structural action, it possesses a functional action (neuroenhancer) as it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in visual signal transmission at both the retinal and post-retinal levels. To date, there is no scientific evidence regarding the effect of citicoline on visual function in glaucoma patients who have undergone filtration surgery. Therefore, the hypothesis of this study is that if surgery increases the likelihood of an improvement in the function of residual RGCs, citicoline could help achieve this objective either by increasing the proportion of patients showing improvement or by increasing the extent of the improvement. The use of a placebo is ethically justified because all patients involved in the study, having signed an informed consent form, will undergo surgical treatment - which is considered the treatment of choice for progressive glaucoma - and the efficacy of citicoline treatment needs to be validated in terms of its ability to alter the course of the disease.
- Conditions
- Glaucoma Therapy
- Being tested
- Citicoline, Placebo
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CiticolineDevice
Citicoline is a mononucleotide composed of ribose, pyrophosphate, cytosine and choline. It is the natural intracellular precursor of phosphatidylcholine. As an intermediate in the synthesis of phosphatidylcholine, citicoline acts at a structural level, promoting the synthesis of membrane phospholipids and inhibiting their degradation.
In addition to its structural action, it has a functional effect (as a neuroenhancer) in that it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in visual signal transmission at both the retinal and post-retinal levels. In addition to its structural effects, it also has a functional effect (as a neuroenhancer) in that it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in the transmission of visual signals at both the retinal and post-retinal levels.
PlaceboOther
solution consisting of the Neurotidine vehicle (placebo)
| Study group | Role | What they receive |
|---|---|---|
| citicolina | Experimental | The experimental group will be treated with citicoline in oral solution (Neurotidine, Omikron, Italy) at a dose of 10 ml per day, starting two weeks before surgery and continuing for the following 24 months. Receives: Device: Citicoline |
| Placebo | Placebo comparator | The placebo arm will receive a solution consisting of the Neurotidine vehicle (placebo) according to the same dosing regimen and schedule. Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in the mean deviation (MD) index
The Mean Deviation (MD) perimetric index is a measure of the average differential light sensitivity of the visual field. It is calculated as the sum of the defects found in the individual tested loci divided by the number of such loci. A higher MD indicates greater damage to the visual field. The MD index is used in conjunction with other perimetric indices to assess light sensitivity and the progression of glaucomatous damage
Measured: 24 months after the operation
Secondary outcomes (6)
Change in the implicit P100 latency measured via PEV (visual evoked potentials)
Measured: 24 months after surgery
Change in p50 amplitude measured using PERG (retinal evoked potentials)
Measured: 24 months after surgery
Incidence of progression as determined by the Glaucoma Progression Analysis (GPA) programme
Measured: 24 months after surgery
Changes in the thickness of the retinal nerve fibre layer (RNFL) and ganglion cell layer (GCC) as measured by SD-OCT (Spectral Domain Optical Coherence Tomography)
Measured: 24 months after surgery
Change in choroidal hypoperfusion areas (dropouts) measured using A-OCT (Optical coherence tomography)
Measured: 24 months after surgery
Changes in the total score and sub-item scores on the NEI-VFQ-25 questionnaire (National Eye Institute Visual Function Questionnaire)
Measured: 24 months after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 May 2026
- Study start10 Aug 2021
- Primary completion31 Dec 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Glaucoma TherapyStudies of the same condition, open and under way.
- More trials run by Fondazione IRCCS Policlinico San Matteo di PaviaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The study design is a single-centre, 1:1 randomised, two-arm, placebo-controlled, double-blind superiority trial. The study protocol involves the recruitment of a sample of 50 glaucoma patients who are to undergo subconjunctival filtering surgery with MMC according to standard indications and procedures defined by the specialist, and who will be randomised to receive citicoline (n = 25) or placebo (n = 25). Recruitment will take place following the signing of the informed consent form by participants. These will be assessed at eleven time points: two weeks prior to surgery (t0); on the day of surgery (t1); one day post-surgery (t2); one month post-surgery (t3); 3 months post-surgery (t4); 6 months post-surgery (t5); 9 months post-surgery (t6); 12 months post-surgery (t7); 15 months post-surgery (t8); 18 months post-surgery (t9); 21 months post-surgery (t10); 24 months post-surgery (t11). Patients will be randomised into the two arms 2 weeks prior to surgery.
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 6 participants (actual)
Sponsor and investigators
- Lead sponsor
- Fondazione IRCCS Policlinico San Matteo di Pavia
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Giovanni Milano, Fondazione IRCCS Policlinico San Matteo di Pavia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07567651
- Sponsor's protocol ID
- CHIRCIT
- Status last verified
- Apr 2026
- First submitted
- 23 Apr 2026
- Last updated
- 5 May 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Single-centre, Randomised, Double-blind Study to Assess the Efficacy of Citicoline Compared With Placebo on Visual Function in Glaucoma Patients Undergoing Subconjunctival Filtering Surgery for Glaucoma
- ClinicalTrials.gov ID
- NCT07567651
- Acronym / sponsor ID
- CHIRCIT
- Conditions
- Glaucoma Therapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 6 participants (actual)
- Lead sponsor
- Fondazione IRCCS Policlinico San Matteo di PaviaUniversity, hospital or other
- Study start
- 10 Aug 2021 (actual)
- Primary completion
- 31 Dec 2025 (actual)
- Study completion
- 31 Dec 2025 (actual)
- First posted
- 5 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Glaucoma is a group of conditions characterised by a progressive loss of retinal ganglion cells (RGCs) and their axons, leading to characteristic changes in the optic nerve head and the retinal nerve fibre layer. If left untreated, the disease has a natural course that can lead to progressive and significant impairment of visual function. Intraocular pressure (IOP) is the main modifiable risk factor for the onset and progression of the disease. The positive effect of surgery on the progression of glaucoma is certainly due to the reduction in IOP levels achieved in the post-operative period, with probable secondary effects on ocular haemodynamics as well. Although IOP reduction is now considered the most potent neuroprotective treatment for glaucoma, it has been shown that good tonometric control may, in some cases, not be sufficient to preserve visual function. There are, in fact, pressure-independent mechanisms involved in the pathogenesis of glaucomatous damage, in which the progressive deterioration and apoptosis of RGCs are linked to mechanisms such as oxidative stress, glutamate neurotoxicity, the inhibition of anterograde transport of neurotrophic factors, and mitochondrial dysfunction. In recent years, various molecules, including cytidine-5'-diphosphocholine (citicoline), have been proposed in combination with hypotensive therapy due to their neuroprotective and neuroenhancing effects. In addition to its structural action, it possesses a functional action (neuroenhancer) as it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in visual signal transmission at both the retinal and post-retinal levels. To date, there is no scientific evidence regarding the effect of citicoline on visual function in glaucoma patients who have undergone filtration surgery. Therefore, the hypothesis of this study is that if surgery increases the likelihood of an improvement in the function of residual RGCs, citicoline could help achieve this objective either by increasing the proportion of patients showing improvement or by increasing the extent of the improvement. The use of a placebo is ethically justified because all patients involved in the study, having signed an informed consent form, will undergo surgical treatment - which is considered the treatment of choice for progressive glaucoma - and the efficacy of citicoline treatment needs to be validated in terms of its ability to alter the course of the disease.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
- Model description
- The study design is a single-centre, 1:1 randomised, two-arm, placebo-controlled, double-blind superiority trial. The study protocol involves the recruitment of a sample of 50 glaucoma patients who are to undergo subconjunctival filtering surgery with MMC according to standard indications and procedures defined by the specialist, and who will be randomised to receive citicoline (n = 25) or placebo (n = 25). Recruitment will take place following the signing of the informed consent form by participants. These will be assessed at eleven time points: two weeks prior to surgery (t0); on the day of surgery (t1); one day post-surgery (t2); one month post-surgery (t3); 3 months post-surgery (t4); 6 months post-surgery (t5); 9 months post-surgery (t6); 12 months post-surgery (t7); 15 months post-surgery (t8); 18 months post-surgery (t9); 21 months post-surgery (t10); 24 months post-surgery (t11). Patients will be randomised into the two arms 2 weeks prior to surgery.
| Arm | Type | Receives |
|---|---|---|
| citicolina | Experimental | Device: CiticolineThe experimental group will be treated with citicoline in oral solution (Neurotidine, Omikron, Italy) at a dose of 10 ml per day, starting two weeks before surgery and continuing for the following 24 months. |
| Placebo | Placebo comparator | Other: PlaceboThe placebo arm will receive a solution consisting of the Neurotidine vehicle (placebo) according to the same dosing regimen and schedule. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- age > 18 years
- Ability to understand the protocol and provide informed consent to participate in the study
- Diagnosis of primary or secondary open-angle glaucoma (PEX - PIG) and the need to undergo subconjunctival filtration surgery due to signs of morphological/functional progression of the condition or failure to achieve target pressure with medical or pre-surgical therapy.
- The diagnosis of glaucoma is defined by the presence of typical ophthalmoscopic damage to the optic nerve head and the consequent visual field defect. In particular, a glaucomatous visual field defect will be considered as such if there is a cluster of 3 or more contiguous points in the pattern deviation plot with a probability of occurrence in the normal population of less than 5%, one of which has a probability of less than 1%, a pattern standard deviation with a probability of less than 5%, or a GHT result outside the normal limits.
- Early to moderate visual field defect, according to the Hodapp-Parrish-Anderson classification, i.e. with MD up to -12 dB, as determined by the Humphrey 24-2 SITA Standard computerised test.
Key exclusion criteria (8 listed)
- Diagnosis of angle-closure glaucoma
- Previous glaucoma surgery (trabeculectomy, valve implantation or placement of other devices, cyclophotocoagulation)
- Previous vitreoretinal or corneal eye surgery
- Visual, neurological or general medical conditions that may affect the visual field, electrophysiological tests, OCT or A-OCT scans
- Systemic administration (oral or parenteral) of cerebral vasoactive drugs, neurotrophic agents, lutein, zeaxanthin, docosahexaenoic acid, ubiquinone and/or its derivatives, citicoline and/or its derivatives within 6 months prior to enrolment in the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CiticolineCiticoline is a mononucleotide composed of ribose, pyrophosphate, cytosine and choline. It is the natural intracellular precursor of phosphatidylcholine. As an intermediate in the synthesis of phosphatidylcholine, citicoline acts at a structural level, promoting the synthesis of membrane phospholipids and inhibiting their degradation. In addition to its structural action, it has a functional effect (as a neuroenhancer) in that it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in visual signal transmission at both the retinal and post-retinal levels. In addition to its structural effects, it also has a functional effect (as a neuroenhancer) in that it increases the synthesis of neurotransmitters such as noradrenaline, acetylcholine, serotonin and dopamine, which are involved in the transmission of visual signals at both the retinal and post-retinal levels. | Device | citicolina |
| Placebosolution consisting of the Neurotidine vehicle (placebo) | Other | Placebo |
Primary outcome
Change in the mean deviation (MD) index
Time frame: 24 months after the operation
The Mean Deviation (MD) perimetric index is a measure of the average differential light sensitivity of the visual field. It is calculated as the sum of the defects found in the individual tested loci divided by the number of such loci. A higher MD indicates greater damage to the visual field. The MD index is used in conjunction with other perimetric indices to assess light sensitivity and the progression of glaucomatous damage
6 secondary outcomes
Change in the implicit P100 latency measured via PEV (visual evoked potentials)
Time frame: 24 months after surgery
Change in p50 amplitude measured using PERG (retinal evoked potentials)
Time frame: 24 months after surgery
Incidence of progression as determined by the Glaucoma Progression Analysis (GPA) programme
Time frame: 24 months after surgery
Changes in the thickness of the retinal nerve fibre layer (RNFL) and ganglion cell layer (GCC) as measured by SD-OCT (Spectral Domain Optical Coherence Tomography)
Time frame: 24 months after surgery
Change in choroidal hypoperfusion areas (dropouts) measured using A-OCT (Optical coherence tomography)
Time frame: 24 months after surgery
Changes in the total score and sub-item scores on the NEI-VFQ-25 questionnaire (National Eye Institute Visual Function Questionnaire)
Time frame: 24 months after surgery
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 May 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Citicoline in people with Glaucoma Therapy, run by Fondazione IRCCS Policlinico San Matteo di Pavia at 1 site in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in the mean deviation (MD) index (time frame: 24 months after the operation). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 May 2026; AzTrials last refreshed its copy on 5 Nov 2026.