Hou Xinyu, Pan Yingzi
Department of Ophthalmology, Peking University First Hospital, No. 8 Xi Shi Ku Street, Xi Cheng District, Beijing 100034, China.
Biomedicines. 2025 May 16;13(5):1213. doi: 10.3390/biomedicines13051213.
: 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. : 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. : 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. : 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.
青光眼是全球不可逆视力丧失的主要原因，其特征是视网膜神经节细胞（RGC）进行性退化和视神经损伤。目前的治疗主要集中在降低眼压（IOP），但未能解决与压力无关的神经退行性机制。褪黑素是一种内源性产生的吲哚胺，因其通过多种细胞途径调节眼压和神经退行性变的潜力而受到关注。本综述通过研究褪黑素的作用机制和新兴给药途径，评估其在青光眼治疗中的相关性。通过PubMed和Medline进行了全面的文献检索，以确定2000年至2025年间发表的关于褪黑素在青光眼中作用的研究。纳入的文章讨论了其对眼压调节、RGC存活、氧化应激、线粒体完整性和炎症的影响。有证据支持褪黑素通过激活MT受体参与降低眼压，以及它与肾上腺素能和酶调节剂的协同作用。此外，它通过减轻氧化应激、预防线粒体功能障碍以及抑制凋亡和炎症级联反应来保护RGC。眼部给药系统的最新进展提高了其生物利用度和治疗潜力。褪黑素是青光眼治疗的多靶点候选药物。需要进一步的临床研究来确定患者的最佳给药策略、给药方法和长期安全性。
