Hussain Azfira, Gopalakrishnan Aparna, Scott Hannah, Seby Chris, Tang Victoria, Ostrin Lisa, Chakraborty Ranjay
Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, South Australia, Australia.
Ophthalmic Physiol Opt. 2023 Nov;43(6):1478-1490. doi: 10.1111/opo.13214. Epub 2023 Aug 11.
Experimental models have implicated the role of melatonin circadian rhythm disruption in refractive error development. Recent studies have examined melatonin concentration and its diurnal patterns on refractive error with equivocal results. This systematic review aimed to summarise the literature on melatonin circadian rhythms in myopia.
PubMed, EMBASE, Web of Science, Scopus, ProQuest Central, LILACS, Cochrane and Medline databases were searched for papers between January 2010 and December 2022 using defined search terms. Seven studies measured melatonin and circadian rhythms in three biological fluids (blood serum, saliva and urine) in both myopes and non-myopes. Morning melatonin concentrations derived from blood serum varied significantly between studies in individuals aged 10-30 years, with a maximum of 89.45 pg/mL and a minimum of 5.43 pg/mL using liquid chromatography and mass spectrometry. The diurnal variation of salivary melatonin was not significantly different between myopes and emmetropes when measured every 4 h for 24 h and quantified with enzyme-linked immunosorbent assay. Significantly elevated salivary melatonin concentrations were reported in myopes compared with emmetropes, aged 18-30 years when measured hourly from evening until their habitual bedtime using liquid chromatography. However, the relationship between dim light melatonin onset and refractive group was inconsistent between studies. The 6-sulphatoxymelatonin concentration derived from overnight urine volume, measured using a double antibody radioimmunoassay, was found to be significantly lower in myopes (29.17 pg/mL) than emmetropes (42.51 pg/mL).
The role of melatonin concentration and rhythm in myopia has not been studied extensively. This systematic review confirms conflicting findings across studies, with potential relationships existing. Future studies with uniform methodological approaches are required to ascertain the causal relationship between melatonin dysregulation and myopia in humans.
实验模型表明褪黑素昼夜节律紊乱在屈光不正发展中起作用。最近的研究探讨了褪黑素浓度及其昼夜模式与屈光不正的关系，但结果不一。本系统评价旨在总结关于近视中褪黑素昼夜节律的文献。
使用特定检索词在PubMed、EMBASE、Web of Science、Scopus、ProQuest Central、LILACS、Cochrane和Medline数据库中检索2010年1月至2022年12月期间的论文。七项研究测量了近视者和非近视者三种生物体液（血清、唾液和尿液）中的褪黑素和昼夜节律。在10至30岁个体中，不同研究间血清中早晨褪黑素浓度差异显著，采用液相色谱和质谱法时，最高为89.45 pg/mL，最低为5.43 pg/mL。当每4小时测量一次唾液褪黑素并持续24小时，并用酶联免疫吸附测定法定量时，近视者和正视者之间唾液褪黑素的昼夜变化无显著差异。当使用液相色谱从晚上到习惯就寝时间每小时测量一次时，18至30岁的近视者唾液褪黑素浓度显著高于正视者。然而，不同研究间暗光褪黑素起始时间与屈光组之间的关系并不一致。使用双抗体放射免疫测定法测量过夜尿量得出的6-硫酸氧褪黑素浓度，近视者（29.17 pg/mL）显著低于正视者（42.51 pg/mL）。
褪黑素浓度和节律在近视中的作用尚未得到广泛研究。本系统评价证实了各研究结果相互矛盾，但可能存在潜在关系。需要采用统一方法的未来研究来确定褪黑素调节异常与人类近视之间的因果关系。
