Melatonin and AMD
Researchers from Case Western Reserve University School of Medicine and Cole Eye Institute explored the potential benefits of melatonin, an over-the-counter sleep aid, in mitigating the risks associated with age-related macular degeneration (AMD). Their study, published in JAMA Ophthalmology, analyzed data from over 200,000 individuals, including those without AMD and those in early stages of the disease. Researchers discovered that melatonin use was potentially linked to a lower risk of developing AMD in individuals without prior history and with a reduced rate of progression from nonexudative to exudative AMD in diagnosed patients. The findings suggest that melatonin may interfere with AMD-related processes, prompting further investigation into its therapeutic potential for preventing or slowing AMD progression.
In response to recent Colorado Retina patient inquiries following the study's release, Dr. Betty Zhang, retina optometrist at Colorado Retina, provides insights into practical implications for AMD patients:
Study Design and Results: This large retrospective study utilized a national health records database spanning from 2008 to 2023. Patients aged 50 and older were divided into two groups based on AMD history: those without AMD and those with dry AMD, then assessed for melatonin use. Patients with at least four instances of melatonin use, spaced at least three months apart, were categorized into the melatonin group; others formed the control group. The study found a reduced risk ratio for both AMD development and progression from dry to neovascular AMD in the melatonin group.
Commentary: The study's retrospective design limits its ability to establish causation. While the results suggest an association between melatonin use and decreased AMD risk and progression, causative conclusions cannot be drawn. Additional variables, such as underlying cardiovascular conditions associated with AMD, and the accuracy of self-reported melatonin use, may have influenced the outcomes. Dr. Zhang emphasizes that while the study warrants further exploration of the melatonin-AMD relationship, it does not currently support melatonin as a recommended prophylactic treatment for AMD development or progression.
Conclusion: Dr. Zhang underscores the importance of distinguishing association from causation, noting that individuals with healthier lifestyles and fewer comorbidities may be inclined to use natural sleep aids like melatonin. She suggests that further research, though challenging due to the accessibility and cost-effectiveness of melatonin, is necessary to fully understand its potential role in managing AMD.
Reference: Melatonin and Risk of Age-Related Macular Degeneration
Hejin Jeong, BA1; Jacqueline K. Shaia, MS1,2; Jonathan C. Markle, MD2; et alKatherine E. Talcott, MD2; Rishi P. Singh, MD2,3 JAMA Ophthalmology. Published online June 6, 2024. doi:10.1001/jamaophthalmol.2024.1822Jhttps://jamanetwork.com/journals/jamaophthalmology/article-abstract/2819801
