Melatonin Could Be the Missing Link in Glaucoma Therapy Offering Hope for Millions Facing Vision Loss
Nikhil Prasad Fact checked by:Thailand Medical News Team May 19, 2025 19 hours, 22 minutes ago
Medical News: A groundbreaking review by scientists from the Department of Ophthalmology at Peking University First Hospital in Beijing is shedding new light on a naturally occurring hormone that could revolutionize how we treat glaucoma—a leading cause of irreversible blindness. The study explores the powerful protective potential of melatonin, a compound best known for regulating sleep, in preserving vision and lowering the pressure inside the eye.
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Melatonin Could Be the Missing Link in Glaucoma Therapy Offering Hope for Millions Facing Vision Loss
Glaucoma affects more than 76 million people globally and is expected to impact over 112 million by 2040. This condition primarily destroys retinal ganglion cells (RGCs)—the neurons that carry visual signals from the eye to the brain—and damages the optic nerve, leading to progressive, irreversible vision loss. While current therapies mainly focus on lowering intraocular pressure (IOP), they do little to address the underlying nerve degeneration. This
Medical News report highlights how melatonin could potentially treat both the pressure and the nerve damage simultaneously.
What Is Melatonin and Why Does It Matter
Melatonin is produced naturally by the pineal gland and also in smaller amounts by the eye itself. Known mostly for regulating sleep cycles, melatonin is also a powerful antioxidant and anti-inflammatory agent. It has now emerged as a promising multitasking therapy for eye diseases like glaucoma. The hormone acts directly on eye tissues to reduce pressure while shielding delicate retinal cells from oxidative stress, mitochondrial dysfunction, inflammation, and cell death.
The researchers performed a thorough review of studies published between 2000 and 2025, analyzing how melatonin influences IOP and neurodegeneration. They examined melatonin’s role in regulating circadian rhythms, its presence in the eye's aqueous fluid, and its effect on various signaling pathways. The study offers strong evidence that melatonin can serve a dual purpose—lowering eye pressure and protecting neurons.
Melatonin Slashes Eye Pressure Through Multiple Mechanisms
Melatonin achieves IOP reduction by activating specific receptors in the eye—MT1, MT2, and especially the lesser-known MT3 receptor. Animal models showed that melatonin and its synthetic analogs could reduce IOP by up to 43%. Some analogs, like 5-MCA-NAT, even outperformed standard glaucoma drugs in both potency and duration.
Notably, melatonin was found to work synergistically with existing medications like timolol and brimonidine, boosting their effectiveness. It also enhances the eye’s natural fluid drainage by affecting ion transport and suppressing the production of carbonic anhydrase enzymes involved in fluid secretion. Oral melatonin supplements (3–10 mg) taken nightly have been shown to modestly reduce morning IOP in human trials.
However, the impact varied among patients—highlighting th
e need for optimized dosages and improved delivery methods. Topical applications and nanocarrier-based formulations are being developed to improve melatonin's bioavailability and prolong its effects.
Powerful Neuroprotection That Goes Beyond Eye Pressure
Glaucoma is not just about pressure. Many patients still experience vision loss despite controlled IOP. Melatonin steps in here as a neuroprotective powerhouse. It neutralizes damaging free radicals, boosts mitochondrial function, reduces inflammation, and prevents cell death in the retina.
In multiple animal models, melatonin was shown to protect RGCs by reducing oxidative stress, preserving mitochondrial structure, preventing inflammatory cytokine release, and halting programmed cell death (including apoptosis and pyroptosis). It even promoted the survival of retinal neurons by regulating energy metabolism and calcium balance.
Moreover, melatonin was shown to modulate autophagy—helping the eye remove damaged proteins and organelles—and to suppress inflammation-triggered pyroptosis via the NF-κB/NLRP3 pathway. In one study, melatonin preserved over 80% of retinal cells in glaucoma-affected mice.
Clinical Applications and Delivery Challenges
Although melatonin shows enormous promise, there are challenges to making it a standard treatment. Oral melatonin has poor bioavailability due to liver metabolism. Eye drops are often washed away too quickly. Intravitreal injections are effective but invasive and risk damaging the retina.
To overcome these hurdles, researchers are developing advanced delivery systems, including nanoparticles, micelles, and nanofibers that can better penetrate the eye and slowly release melatonin over time. Some formulations, like melatonin-loaded nanomicelles, have already shown superior IOP-lowering and retinal cell-preserving results in experimental models compared to conventional drugs.
A Multi-Target Strategy That Could Redefine Glaucoma Care
The strength of melatonin lies in its ability to tackle glaucoma from multiple angles. Unlike current therapies that focus solely on IOP, melatonin protects vision by preserving retinal ganglion cells, modulating oxidative stress, stabilizing mitochondria, and reducing inflammation.
It can potentially slow or stop the progression of the disease, not just manage its symptoms. With advancements in drug delivery technologies and more clinical trials on the horizon, melatonin and its analogs may soon become mainstream in glaucoma therapy.
Conclusion
Melatonin, long valued for its role in regulating sleep, is emerging as a potential game-changer in the battle against glaucoma. This natural compound offers both intraocular pressure-lowering effects and robust neuroprotection—two crucial components in preventing vision loss. Through its antioxidant, anti-inflammatory, and mitochondrial-supporting actions, melatonin targets the underlying mechanisms of glaucomatous damage, not just the symptoms. With the rise of innovative delivery systems such as nanocarriers, there is increasing hope that melatonin-based therapies could soon offer an effective, multi-pronged approach to preserving eyesight in millions of patients worldwide. Future large-scale clinical trials are needed to confirm optimal dosages, safety profiles, and long-term outcomes, but the scientific foundation is already solid and compelling.
The study findings were published in the peer reviewed journal: Biomedicines.
https://www.mdpi.com/2227-9059/13/5/1213
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