Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection

<b>Background</b>: Glaucoma is a leading cause of irreversible visual loss worldwide, characterized by progressive retinal ganglion cell (RGC) degeneration and optic nerve damage. Current therapies mainly focus on lowering intraocular pressure (IOP), yet fail to address pressure-independ...

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Main Authors: Xinyu Hou, Yingzi Pan
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/5/1213
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author Xinyu Hou
Yingzi Pan
author_facet Xinyu Hou
Yingzi Pan
author_sort Xinyu Hou
collection DOAJ
description <b>Background</b>: Glaucoma is a leading cause of irreversible visual loss worldwide, characterized by progressive retinal ganglion cell (RGC) degeneration and optic nerve damage. Current therapies mainly focus on lowering intraocular pressure (IOP), yet fail to address pressure-independent neurodegenerative mechanisms. Melatonin, an endogenously produced indoleamine, has gained attention for its potential in modulating both IOP and neurodegeneration through diverse cellular pathways. This review evaluates the therapeutic relevance of melatonin in glaucoma by examining its mechanistic actions and emerging delivery approaches. <b>Methods</b>: A comprehensive literature search was conducted via PubMed and Medline to identify studies published between 2000 and 2025 on melatonin’s roles in glaucoma. Included articles discussed its effects on IOP regulation, RGC survival, oxidative stress, mitochondrial integrity, and inflammation. <b>Results</b>: Evidence supports melatonin’s involvement in IOP reduction via MT receptor activation and its synergism with adrenergic and enzymatic regulators. Moreover, it protects RGCs by mitigating oxidative stress, preventing mitochondrial dysfunction, and inhibiting apoptotic and inflammatory cascades. Recent advances in ocular drug delivery systems enhance its bioavailability and therapeutic potential. <b>Conclusions</b>: Melatonin represents a multi-target candidate for glaucoma treatment. Further clinical studies are necessary to establish optimal dosing strategies, delivery methods, and long-term safety in patients.
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spelling doaj-art-7585bd393b2d447a900a15ae907f15132025-08-20T02:33:40ZengMDPI AGBiomedicines2227-90592025-05-01135121310.3390/biomedicines13051213Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and NeuroprotectionXinyu Hou0Yingzi Pan1Department of Ophthalmology, Peking University First Hospital, No. 8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, ChinaDepartment of Ophthalmology, Peking University First Hospital, No. 8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China<b>Background</b>: Glaucoma is a leading cause of irreversible visual loss worldwide, characterized by progressive retinal ganglion cell (RGC) degeneration and optic nerve damage. Current therapies mainly focus on lowering intraocular pressure (IOP), yet fail to address pressure-independent neurodegenerative mechanisms. Melatonin, an endogenously produced indoleamine, has gained attention for its potential in modulating both IOP and neurodegeneration through diverse cellular pathways. This review evaluates the therapeutic relevance of melatonin in glaucoma by examining its mechanistic actions and emerging delivery approaches. <b>Methods</b>: A comprehensive literature search was conducted via PubMed and Medline to identify studies published between 2000 and 2025 on melatonin’s roles in glaucoma. Included articles discussed its effects on IOP regulation, RGC survival, oxidative stress, mitochondrial integrity, and inflammation. <b>Results</b>: Evidence supports melatonin’s involvement in IOP reduction via MT receptor activation and its synergism with adrenergic and enzymatic regulators. Moreover, it protects RGCs by mitigating oxidative stress, preventing mitochondrial dysfunction, and inhibiting apoptotic and inflammatory cascades. Recent advances in ocular drug delivery systems enhance its bioavailability and therapeutic potential. <b>Conclusions</b>: Melatonin represents a multi-target candidate for glaucoma treatment. Further clinical studies are necessary to establish optimal dosing strategies, delivery methods, and long-term safety in patients.https://www.mdpi.com/2227-9059/13/5/1213melatoninglaucomaintraocular pressureretinal ganglion cellsneuroprotectionnanocarriers
spellingShingle Xinyu Hou
Yingzi Pan
Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
Biomedicines
melatonin
glaucoma
intraocular pressure
retinal ganglion cells
neuroprotection
nanocarriers
title Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
title_full Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
title_fullStr Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
title_full_unstemmed Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
title_short Melatonin in Glaucoma: Integrative Mechanisms of Intraocular Pressure Control and Neuroprotection
title_sort melatonin in glaucoma integrative mechanisms of intraocular pressure control and neuroprotection
topic melatonin
glaucoma
intraocular pressure
retinal ganglion cells
neuroprotection
nanocarriers
url https://www.mdpi.com/2227-9059/13/5/1213
work_keys_str_mv AT xinyuhou melatonininglaucomaintegrativemechanismsofintraocularpressurecontrolandneuroprotection
AT yingzipan melatonininglaucomaintegrativemechanismsofintraocularpressurecontrolandneuroprotection