Melatonin mitigates disrupted circadian rhythms, lowers intraocular pressure, and improves retinal ganglion cells function in glaucoma

Mar 17, 2021Journal of pineal research

Melatonin may help restore daily rhythms, reduce eye pressure, and improve nerve cell function in glaucoma

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Abstract

Melatonin administration for 90 days improved the stability of circadian rhythms in patients with glaucoma.

Melatonin enhanced the alignment of the body temperature circadian rhythm with intraocular pressure (IOP).
A time-dependent decrease in IOP and IOP standard deviation was observed with melatonin treatment.
Individuals with higher initial 24-hour IOP means experienced more significant reductions in IOP.
Melatonin improved retinal ganglion cell function, particularly in patients with advanced glaucoma.
In advanced glaucoma, melatonin's effects on sleep and mood were more pronounced.
Delayed salivary melatonin and body temperature phases were found in carriers of the MTNR1B G-allele with advanced glaucoma.

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Glaucoma is a progressive optic neuropathy associated with damage to retinal ganglion cells (RGCs) and disrupted circadian rhythms. Melatonin is a promising substance to ameliorate glaucoma-associated compromised circadian rhythms, sleep, mood, and retinal cells function. However, studies estimating melatonin effects in glaucoma are currently lacking. Therefore, In this study, we investigated the effect of long-term (daily at 10:30 pm for 90 days) oral melatonin administration on systemic (Tb) and local to the organ of vision (IOP) circadian rhythms, pattern electroretinogram (PERG), sleep, and mood, depending on glaucoma stage in patients diagnosed with stable or advanced primary open-angle glaucoma. In a laboratory study in 15 of them, 24-hour records of salivary melatonin were obtained and MTNR1B receptor gene polymorphism was assessed. Melatonin increased the stability of the Tb circadian rhythm by improving its phase alignment and alignment with IOP. Melatonin time-dependently decreased IOP and IOP standard deviation (SD). IOP 24-hour mean and IOP SD decreases were more pronounced in individuals with the higher initial 24-hour IOP mean. Melatonin improved RGCs function in advanced glaucoma; N95 amplitude increase correlated positively with RGCs loss. The beneficial effects of melatonin on sleep and mood were greater in advanced glaucoma. Finally, delayed salivary melatonin and Tb phases were observed in MTNR1B G-allele carriers with advanced glaucoma. Combined, these results provide evidence for melatonin efficiency in restoring disrupted circadian rhythms in glaucoma with different effects of melatonin on systemic vs. local circadian rhythms, indicating that a personalized strategy of melatonin administration may further refine its treatment benefits.

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Melatonin mitigates disrupted circadian rhythms, lowers intraocular pressure, and improves retinal ganglion cells function in glaucoma

Abstract

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