Clinical Ophthalmology (Mar 2025)
Age-Related Macular Degeneration and Circadian Preference
Abstract
Estefany Garces,1 Katarzyna Slota,2 Michael W Stewart,3 Maria P Guzman,4 Natalia M Werninck,1 Pablo R Castillo1 1Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA; 2Northwest Community Healthcare, Schaumburg, IL, USA; 3Division of Ophthalmology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA; 4Sleep & Obesity Medicine, St Petersburg, FL, USACorrespondence: Pablo R Castillo, Division of Pulmonary, Allergy and Sleep Medicine, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA, Email [email protected]: Age-related macular degeneration (AMD) is the leading cause of blindness in developed nations. Within the retina, a subset of cells, called melanopsin-containing intrinsically photosensitive retinal ganglion cells, are implicated in circadian rhythms, prompting a search for a potential connection between circadian behavior and AMD. Our objective was to compare the chronotype (ie, preference for morning or evening activity) of individuals with AMD to that of those without ocular conditions.Patients and Methods: The Horne-Östberg Morningness-Eveningness questionnaire was administered to previously screened patients with wet AMD who received bilateral anti–vascular endothelial growth factor eye injections (study participants) as well as those without eye pathology (controls). Thirty-one study participants and 19 controls completed the survey and were included in the analysis. We used Wilcoxon rank sum test and Fisher exact test for continuous and categorical variables respectively.Results: Study participants had a higher median age compared to controls (83 vs 75, P< 0.001). No significant difference in body mass index was observed between respondents. While the disparity in survey responses between study participants and controls was generally not statistically significant, more study participants struggled with attending exercises between 7:00 and 8:00 in the morning compared to controls (45% vs 21%, P=0.02). Additionally, fewer study participants expressed the need to sleep before 10:15 pm compared to controls (55% vs 63%, P=0.04). Study participants tended to have a delayed sleep-wake cycle.Conclusion: In this pilot study, study participants encountered greater challenges with morning exercise compared to controls. Nonetheless, there was no significant difference in chronotype between study participants and controls. The study could serve as a foundation for more extensive research exploring the interplay between vision loss and circadian rhythms.Plain Language Summary: Age-related macular degeneration (AMD) is a leading cause of blindness in developed nations. Researchers are exploring connections between AMD and circadian rhythms, particularly focusing on certain cells in the eye. This study aimed to compare the daily activity preferences (chronotypes) of individuals with AMD to those without eye conditions. In this study, participants with AMD and controls without eye pathology completed the Horne-Östberg Morningness-Eveningness questionnaire to identify their circadian preference. Findings indicated that individuals with AMD experienced more challenges with morning exercise and tended to prefer later bedtimes compared to controls. Despite these trends, there was no significant difference in chronotype between the groups. This pilot study suggests that participants with AMD may exhibit a preference for a delayed sleep-wake cycle and encounter difficulties with morning activities. However, further research is necessary to fully understand the relationship between AMD and circadian rhythms.Keywords: chronotypes, circadian rhythm, maculopathy, retinal ganglion cells, pilot study, surveys and questionnaires
