Preventative Effect of Melatonin in Patients with Age-Related Macular Degeneration (AMD)

by | Jul 23, 2024 | 2024, Eye Health, Melatonin, Recent Articles

Written by Chrystal Moulton, Science Writer. Patients who were taking melatonin had a significantly reduced risk of AMD progression compared to those who were not taking melatonin across all three subgroups.

woman at eye doctorMelatonin, which is known for regulating sleep and wake cycles, has also been shown to possess anti-inflammatory, antioxidant, mitochondrial protective properties and anti-angiogenic properties1-4. Some studies have shown that melatonin could improve damaged retinal cells both in vitro and in vivo5. For individuals suffering from age-related macular degeneration [AMD], melatonin could be a viable option and addition to existing treatment. One study showed that patients with age-related macular degeneration [AMD] treated with 3mg melatonin had fewer pathological macular changes and a slower decline in visual acuity6. In the current trial, researchers investigated potential associations between melatonin use and the development and progression of AMD in the US population7.

This study used data from the TriNet X database containing de-identified electronic health records of more than 95 million people across more than 60 US health care organizations. The study was designed as a retrospective cohort study comparing patients who were taking melatonin [melatonin cohort] versus those who were not [control cohort] against two primary risks: development of AMD and progression of non-exudative AMD to exudative AMD. The two groups (individuals not taking melatonin [control] versus individuals prescribed melatonin [melatonin cohort]) was further categorized into two groups for comparative analysis: individuals with no history of AMD [AMD-naive] versus individuals with the history of AMD. The melatonin versus non-melatonin groups were further divided into 3 subgroups based on age: 50 years or older, 60 years or older and 70 years or older. In all, there are a total of 6 subgroups in the melatonin cohort and control cohort used in the analysis. Researchers compared the melatonin cohort group and the control to assess the risk of developing AMD during an observational period of one year. For the control AMD-naive group, the patient’s first record of an eye examination was the beginning of the one-year observation period. In the melatonin AMD-naive group, the beginning of the one-year observation was the patient’s first examination and record of melatonin use. Diagnosis of non-exudative AMD was the beginning of the one-year observation period for individuals in the control AMD group while diagnosis of non-exudative AMD and melatonin use was the beginning of the one year observation for individuals in the melatonin AMD group. Researchers also conducted a series of sensitivity analysis and a negative control to ensure reliability of the results.

At baseline, the analysis included 121,523 patients over the age of 50 in the AMD-naive group (individuals with no history of AMD). Researchers found that patients who were taking melatonin in the AMD-naive group (individuals with no history of AMD) had a significantly lower risk of developing AMD compared to those not taking melatonin [control] (P< 0.05). This result was also observed in patients 60 years and older [R = 0.40, P<0.05] and patients 70 years and older [R = 0.22, P<0.05]. Furthermore, researchers saw similar results in patients with a history of AMD. The final analysis of patients with a history of AMD included 66,253 individuals over the age of 50. Patients who were taking melatonin had a significantly reduced risk of AMD progression compared to those who were not taking melatonin across all three subgroups [≥50 years old: RR = 0.44, P<0.05; ≥60 years old: R = 0.38, P<0.05; ≥70 years old: R = 0.40, P <0.05]. Sensitivity analysis and negative control supported the reliability of these results.

Overall, this study demonstrated that melatonin could slow the development and progression of age-related macular degeneration [AMD] in individuals over the age of 50. Additional trials will be needed to verify the effectiveness and mechanism of action through which melatonin could aid in the treatment of AMD.

Source: Jeong, Hejin, Jacqueline K. Shaia, Jonathan C. Markle, Katherine E. Talcott, and Rishi P. Singh. “Melatonin and Risk of Age-Related Macular Degeneration.” JAMA ophthalmology (2024).

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Posted July 23, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

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