Circadian Rhythm and Glaucoma: What do We Know?
Ciulla Lauren, Moorthy Meena, Mathew Sunu, Siesky Brent, Verticchio Vercellin Alice C, Price David, Januleviciene Ingrida, Harris Alon
AI Summary
This review found nocturnal IOP peaks and BP troughs create low ocular perfusion, impacting glaucoma progression. Managing circadian rhythm and nocturnal IOP is key for treatment.
Abstract
Purpose
The current understanding of circadian regulation disorders and their involvement in glaucoma pathophysiology are poorly understood, yet they may have a substantial impact on the onset and progression of glaucoma. Herein, we review and summarize all the available literature on circadian rhythm disorder and glaucoma to uncover the impact on glaucoma risk, and we highlight future research and potential novel targets for glaucoma management.
Materials and methods
A review of the relevant literature was performed through PubMed through August 1, 2019.
Results
Within a normal circadian rhythm, intraocular pressure (IOP) peaks at night, whereas blood pressure (BP) troughs at night. High nocturnal IOP coupled with low nocturnal systemic BP results in low ocular perfusion pressure and potential for unobserved damage to retinal tissues and the optic nerve. Circadian-related melatonin and sleep disorders also result in changes in IOP and ocular perfusion pressure that lead to the progression of glaucoma. In addition, impaired perception of light input due to glaucoma can subsequently lead to abnormal serum levels of melatonin, resulting in circadian rhythm misalignment. This disruption of the circadian rhythm also contributes to sleep and mood disorders, common in individuals with glaucoma. As regards treatment, glaucoma medications that lower nocturnal IOP without influencing nocturnal BP or diminishing circadian variation seem most effective.
Conclusions
Glaucoma progression is influenced by multiple physiological factors regulated by the circadian rhythm. Progression of the disease may also cause physiological changes that lead to circadian-related issues. Further research is warranted on the diurnal cycle, melatonin-mediated processes, and their influence on glaucoma management.
MeSH Terms
Shields Classification
Key Concepts5
Within a normal circadian rhythm, intraocular pressure (IOP) peaks at night, whereas blood pressure (BP) troughs at night, which results in low ocular perfusion pressure and potential for unobserved damage to retinal tissues and the optic nerve.
Circadian-related melatonin and sleep disorders result in changes in intraocular pressure (IOP) and ocular perfusion pressure that lead to the progression of glaucoma.
Impaired perception of light input due to glaucoma can subsequently lead to abnormal serum levels of melatonin, resulting in circadian rhythm misalignment, which also contributes to sleep and mood disorders common in individuals with glaucoma.
Glaucoma medications that lower nocturnal intraocular pressure (IOP) without influencing nocturnal blood pressure (BP) or diminishing circadian variation seem most effective for treatment.
Glaucoma progression is influenced by multiple physiological factors regulated by the circadian rhythm, and the progression of the disease may also cause physiological changes that lead to circadian-related issues.
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