NAD⁺ metabolism and eye diseases: current status and future directions

Currently, there are no truly effective treatments for a variety of eye diseases, such as glaucoma, age-related macular degeneration (AMD), and inherited retinal degenerations (IRDs). These conditions have a significant impact on patients' quality of life and can be a burden on society. However, these diseases share a common pathological process of NAD⁺ metabolism disorders. They are either associated with genetically induced primary NAD⁺ synthase deficiency, decreased NAD⁺ levels due to aging, or enhanced NAD⁺ consuming enzyme activity during disease pathology. In this discussion, we explore the role of NAD⁺ metabolic disorders in the development of associated ocular diseases and the potential advantages and disadvantages of various methods to increase NAD⁺ levels. It is essential to carefully evaluate the possible adverse effects of these methods and conduct a more comprehensive and objective assessment of their function before considering their use.