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

Journal of pineal research
May 1, 2021
Denis Gubin et al. (9 authors)
Clinical TrialJournal ArticleHuman StudyClinical
Study Details

Study Goal

The researchers aimed to investigate the effects of long-term melatonin administration on circadian rhythms, intraocular pressure (IOP), retinal ganglion cell function, sleep, and mood in patients with stable or advanced primary open-angle glaucoma.

Results Summary

Melatonin improved the stability of systemic and local circadian rhythms, reduced IOP and its variability, enhanced retinal ganglion cell function in advanced glaucoma, and improved sleep and mood, with greater benefits observed in advanced cases. Delayed melatonin and body temperature phases were noted in MTNR1B G-allele carriers with advanced glaucoma.

Population

Patients diagnosed with stable or advanced primary open-angle glaucoma (15 participants in the laboratory study).

Effective Dosage

Daily at 10:30 pm (specific dosage amount not provided).

Duration

90 days

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
long-term oral melatonin administration
increase
Tb circadian rhythm
patients diagnosed with stable or advanced primary open-angle glaucoma
-
increased the stability of
#1
long-term oral melatonin administration
increase
Tb circadian rhythm
patients diagnosed with stable or advanced primary open-angle glaucoma
-
improved phase alignment of
#2
long-term oral melatonin administration
increase
IOP
patients diagnosed with stable or advanced primary open-angle glaucoma
-
improved alignment of Tb circadian rhythm with
#3
long-term oral melatonin administration
decrease
IOP
patients diagnosed with stable or advanced primary open-angle glaucoma
-
time-dependently decreased
#4
long-term oral melatonin administration
decrease
IOP standard deviation (SD)
patients diagnosed with stable or advanced primary open-angle glaucoma
-
time-dependently decreased
#5
long-term oral melatonin administration
decrease
IOP 24-hour mean
individuals with the higher initial 24-hour IOP mean
more pronounced
decreased
#6
long-term oral melatonin administration
decrease
IOP SD
individuals with the higher initial 24-hour IOP mean
more pronounced
decreased
#7
long-term oral melatonin administration
increase
RGCs function
patients with advanced glaucoma
-
improved
#8
long-term oral melatonin administration
increase
N95 amplitude
patients with advanced glaucoma
-
increased
#9
long-term oral melatonin administration
increase
sleep
patients with advanced glaucoma
greater
had beneficial effects on
#10
long-term oral melatonin administration
increase
mood
patients with advanced glaucoma
greater
had beneficial effects on
#11
-
neutral
delayed salivary melatonin phases
MTNR1B G-allele carriers with advanced glaucoma
-
were observed
#12
-
neutral
delayed Tb phases
MTNR1B G-allele carriers with advanced glaucoma
-
were observed
#13
Abstract

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.

Medical Subject Headings (MeSH)
AgedCircadian RhythmFemaleGlaucoma, Open-AngleHumansIntraocular PressureMaleMelatoninMiddle AgedRetinal Ganglion Cells
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations38
Citations/Year9.5
Relative Citation Ratio3.94
NIH Percentile89.9%
Research Impact Scores
APT Score0.75
Weight Score2.62
Normalized Score0.69
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