Melatonin Levels in Patients with Primary Open Angle Glaucoma with High or Low Intraocular Pressure.

PURPOSE: To evaluate circulatory melatonin levels by assessing nocturnal urinary excretion of 6-sulfatoxymelatonin (aMT6s) in patients with primary open angle glaucoma (POAG) and to compare the high-tension group and the low-tension group.

METHODS: This study included 80 eyes of 41 POAG patients and 87 eyes of 44 control subjects. POAG group was further classified into high-tension group and low-tension group according to the pretreatment intraocular pressure. The first urine in the morning was collected and aMT6s were measured using a commercial ELISA kit. Urinary aMT6s levels were expressed as ng aMT6s/mg creatinine. Differences in melatonin levels among the control and POAG subgroups were evaluated by generalized estimating equation adjusting age, sex, sleep duration, and inter-eye correlation.

RESULTS: Urinary aMT6s/creatinine ratio did not differ between POAG and control group (P=0.097). The difference in the aMT6s/creatinine ratio between the three groups- high-tension group with baseline intraocular pressure (IOP) ≥21▒mmHg (19.74±3.12▒ng/mg), low-tension glaucoma group with baseline IOP < 21▒mmHg (26.71±3.47▒ng/mg), and control group (30.35±3.05▒ng/mg)-was statistically significant (P=0.046). Post hoc analysis revealed that the difference between the control and high-tension glaucoma groups was significant (P=0.014), while the difference between the control and low-tension glaucoma groups was not (P=0.436).

CONCLUSION: This study found low melatonin levels in high-tension glaucoma compared with the control.