Effects of long-term methylcobalamin treatment on the progression of visual field defects in normal-tension glaucoma

Abstract

ObjectivesThe objectives of this prospective study were to examine the efficacy of methylcobalamin in preventing the deterioration of glaucomatous visual field defects, and to evaluate the relationship between the progression of visual field defects and other clinical characteristics using the Cox proportional hazards model. MethodsPatients with normal-tension glaucoma (NTG) who met the selection criteria were divided into a treatment group and an untreated control group. The treatment group consisted of 14 patients and 14 eyes; they were administered 1500 μg/d of methylcobalamin orally for 4 years beginning in April 1994. The control group consisted of 22 patients and 22 eyes. Both groups had similar characteristics in terms of age, systemic complications, intraocular pressure (IOP), refraction, and baseline visual field (mean deviation and corrected pattern standard deviation). ResultsAfter 4 years of peroral methylcobalamin treatment, 2 eyes of 2 patients (14%) in the treatment group and 13 eyes of 13 patients (59%) in the control group showed deterioration of visual field defect. The deterioration in the control group was significant compared with that in the treatment group (P = 0.008). According to the Cox proportional hazards model, peroral methylcobalamin treatment and mean IOP during the follow-up period showed significant correlation to the progression of visual field defect. ConclusionsThese findings suggest that peroral methylcobalamin might be useful in the treatment of visual field defects in patients with NTG.