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In a randomized, double-blind, placebo-controlled trial in 78 patients with progressive open-angle glaucoma (despite intraocular pressures of 18 mm Hg), use of citicoline eyedrops for three years blunted the decrease in retinal nerve fiber layer thickness compared to use of placebo eyedrops (91)
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The critical insight is that leucine by itself depleted muscle isoleucine by 55% and valine by 42% during recovery, creating substrate limitations for protein synthesis
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