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Melatonin and glaucoma: Current insights and clinical prospectives
A Martucci1, R Rosa1, F Aiello1
1Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
Archivos De La Sociedad Espanola De Oftalmologia
|April 18, 2026
Summary
Melatonin plays a key role in glaucoma, impacting sleep, circadian rhythms, and retinal health. Supplementation shows promise for neuroprotection and lowering intraocular pressure (IOP) beyond traditional treatments.
Area of Science:
- Ophthalmology
- Neuroscience
- Chronobiology
Background:
- Glaucoma involves progressive retinal ganglion cell (RGC) loss, often continuing despite controlled intraocular pressure (IOP).
- Sleep disturbances and circadian dysfunction are common in glaucoma patients.
- Melatonin, a hormone regulating sleep and circadian rhythms, is implicated in glaucoma pathophysiology.
Purpose of the Study:
- To review the role of melatonin in glaucoma.
- To explore its connection to sleep and circadian rhythm disruptions.
- To assess its therapeutic potential for neuroprotection and IOP management.
Main Methods:
- A structured narrative search of PubMed using "glaucoma" and "melatonin" keywords.
- Qualitative synthesis of findings from clinical, experimental, and translational studies.
- Integration of data on melatonin signaling, receptor distribution, and therapeutic effects.
Main Results:
- Melatonin secretion is reduced in glaucoma patients, especially in advanced stages.
- Melatonin receptors are present in ocular tissues, including RGCs, influencing circadian regulation and IOP.
- Melatonin deficiency impairs RGC function and promotes neurodegeneration.
- Exogenous melatonin and analogues demonstrate IOP-lowering and neuroprotective effects in studies.
- Novel delivery systems may improve melatonin's ocular efficacy.
Conclusions:
- Melatonin has a multifaceted role in glaucoma, affecting circadian rhythms, sleep, IOP, and RGC neuroprotection.
- Melatonin deficiency contributes to glaucoma progression.
- Therapeutic strategies involving melatonin warrant further investigation for comprehensive glaucoma management.
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