Retinal neurodegeneration as accelerated ocular aging: a review of nutritional and metabolic supplements
7 affiliations
- 1Massachusetts Eye and Ear Infirmary, Boston, MA, United States
- 2Department of Integrative Pathophysiology and Therapies, Andalusian Molecular Biology and Regenerative Medicine Centre (CABIMER), Seville, Spain
- 3Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
- 4University of Tulsa, Tulsa, OK, United States
- 5Harvard Medical School, Boston, MA, United States
- 6Saint Louis University, St. Louis, MO, United States
- 7Department of Ophthalmology, Virgen Macarena University Hospital, Sevilla, Spain
Abstract
Retinal neurodegeneration is a major cause of irreversible vision loss and a shared feature of age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma (GL). Increasing evidence suggests that these conditions share important pathways with retinal aging, including mitochondrial dysfunction, metabolic insufficiency, redox imbalance, chronic low-grade inflammation, and progressive neuronal vulnerability. While antioxidant and micronutrient supplementation, most notably the Age-Related Eye Disease Study (AREDS) formulations, has demonstrated benefit in selected AMD populations, emerging metabolic and nutraceutical strategies targeting aging-related pathways are of unproven benefit. In this review, following a brief overview of the current landscape of investigated supplements, we synthesize preclinical and clinical evidence for a group of metabolic supplements, including nicotinamide adenine dinucleotide (NAD+) boosters, citicoline, pyruvate, and omega-3 fatty acids, that directly modulate mitochondrial bioenergetics, cellular redox state, membrane integrity, and neuroinflammatory signaling—pathways that are recognized hallmarks of biological aging and are particularly relevant to aging-related processes implicated in retinal neurodegeneration. Using a structured literature and clinical trial search, we summarize mechanistic insights and translational findings across AMD, DR, and glaucoma, emphasizing convergence on core pathways linking retinal neurodegeneration and ocular aging. Overall, current evidence supports biological plausibility and early functional or biomarker signals for these agents, particularly in glaucoma and diabetic retinal disease, although long-term efficacy remains unproven. Framing retinal disease at the intersection of neurodegeneration and aging biology, this review highlights metabolic supplementation as a promising but evolving strategy for preserving retinal function.
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BibTeX
@article{moshtaghion2026retinal,
title = {{Retinal neurodegeneration as accelerated ocular aging: a review of nutritional and metabolic supplements}},
author = {Seyed Mohamadmehdi Moshtaghion and Maryam Shayan and Sarvesh Ramakrishnan and Andrew Ham and Ashkan Shafaei Gharehkoshan and Michael G. Morley and Nazlee Zebardast and Francisco Javier Díaz-Corrales and Enrique Rodríguez de la Rúa and Deeba Husain and Lucia Sobrin and Tobias Elze and David S. Friedman and Mohammad Eslami},
journal = {Frontiers in Aging},
year = {2026},
month = oct,
doi = {10.3389/fragi.2026.1912337},
url = {https://doi.org/10.3389/fragi.2026.1912337},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Retinal neurodegeneration as accelerated ocular aging: a review of nutritional and metabolic supplements
AU - Seyed Mohamadmehdi Moshtaghion
AU - Maryam Shayan
AU - Sarvesh Ramakrishnan
AU - Andrew Ham
AU - Ashkan Shafaei Gharehkoshan
AU - Michael G. Morley
AU - Nazlee Zebardast
AU - Francisco Javier Díaz-Corrales
AU - Enrique Rodríguez de la Rúa
AU - Deeba Husain
AU - Lucia Sobrin
AU - Tobias Elze
AU - David S. Friedman
AU - Mohammad Eslami
PY - 2026
DA - 2026/10/12
JO - Frontiers in Aging
DO - 10.3389/fragi.2026.1912337
UR - https://doi.org/10.3389/fragi.2026.1912337
AB - Retinal neurodegeneration is a major cause of irreversible vision loss and a shared feature of age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma (GL). Increasing evidence suggests that these conditions share important pathways with retinal aging, including mitochondrial dysfunction, metabolic insufficiency, redox imbalance, chronic low-grade inflammation, and progressive neuronal vulnerability. While antioxidant and micronutrient supplementation, most notably the Age-Related Eye Disease Study (AREDS) formulations, has demonstrated benefit in selected AMD populations, emerging metabolic and nutraceutical strategies targeting aging-related pathways are of unproven benefit. In this review, following a brief overview of the current landscape of investigated supplements, we synthesize preclinical and clinical evidence for a group of metabolic supplements, including nicotinamide adenine dinucleotide (NAD+) boosters, citicoline, pyruvate, and omega-3 fatty acids, that directly modulate mitochondrial bioenergetics, cellular redox state, membrane integrity, and neuroinflammatory signaling—pathways that are recognized hallmarks of biological aging and are particularly relevant to aging-related processes implicated in retinal neurodegeneration. Using a structured literature and clinical trial search, we summarize mechanistic insights and translational findings across AMD, DR, and glaucoma, emphasizing convergence on core pathways linking retinal neurodegeneration and ocular aging. Overall, current evidence supports biological plausibility and early functional or biomarker signals for these agents, particularly in glaucoma and diabetic retinal disease, although long-term efficacy remains unproven. Framing retinal disease at the intersection of neurodegeneration and aging biology, this review highlights metabolic supplementation as a promising but evolving strategy for preserving retinal function.
SN - 2673-6217
ER -