Exploring How Glaucoma Affects Mood and Sleep Problems

Reviewed by Preeti Subramanian, PhD, BrightFocus Foundation 

People with vision loss from glaucoma often experience sleep problems or mood changes. A study from the Centers for Disease Control and Prevention found that one in four adults with vision loss reported having anxiety or depression.​ Other research has shown that people with glaucoma have higher rates of sleep disorders, compared to those without glaucoma.​

Shifts in mood and sleep may be due to physical changes caused by glaucoma in a certain type of retinal ganglion cells. BrightFocus Foundation National Glaucoma Research grant recipient Xiaorong Liu, PhD ​,​ believes this may be the case.

She and co-investigator Ignacio Provencio, PhD, are studying a specific type of cell known as intrinsically photosensitive retinal ganglion cells. These cells carry light information from the eyes to the brain for reasons other than vision, such as regulating sleep and mood, according to Dr. Liu.

With this research, they hope to understand how changes in these cells due to glaucoma impact non-visual responses to light in glaucoma models. If successful, their research may one day lead to a way to relieve the light-related ​mood and sleep​ challenges of glaucoma.

Retinal Ganglion Cells Affect Mood and Sleep

The discovery of intrinsically photosensitive retinal ganglion cells stemmed from research two decades ago by Dr. Provencio and his colleagues. In their lab, they identified a​ ​pigment ​called melanopsin that ​undergoes a chemical change when it is exposed to blue light,​

​​​After Dr. Liu moved to Virginia, her lab was "a few steps away" from Dr. Provencio's. They soon began discussing potential collaborations, she said. They came up with the idea ​​to examine how glaucoma results in intrinsically photosensitive retinal ganglion cells being damaged and dying. Similar changes occur to retinal ganglion cells that carry vision-related light information.

​​"[Intrinsically photosensitive retinal ganglion cells] play key roles in things like regulating mood and sleep based on light exposure," Dr. Liu explained. "We're interested in understanding how different types of [these cells] survive in glaucoma and how this affects these light-driven, non-visual functions."​​​

​​Based on their initial idea, they designed experiments to test it, Dr. Liu explained. As they delved deeper, new ideas about the role of these cells emerged. "This journey of discovery, where we're constantly learning and uncovering new things, makes the research experience both exciting and deeply fulfilling," she said​

With funding from National Glaucoma Research, Drs. Liu and Provencio will focus on how glaucoma leads to sleep changes and anxiety-like behaviors in glaucoma models. They will also look at the effect that glaucoma has on sleep and mood brain circuits influenced by intrinsically photosensitive retinal ganglion cells. This will provide ​a ​greater understanding of how light affects non-visual responses in the brain, Dr. Liu said. This includes both the mechanisms of how this works and the communication pathways involved.

Research Lays Groundwork for Future Therapies

While this is early-stage research and not yet ready for testing in people, it provides biological insights into an issue that affects many people with glaucoma and their loved ones. More research is needed to better understand the mechanisms involved, such as how light information carried by intrinsically photosensitive retinal ganglion cells influences the brain circuits involved in sleep and mood. And how glaucoma alters the flow of non-visual signals from the eye to the brain.

​​These kinds of insights help drive the development of new treatments that could improve people's quality of life. Future research will examine potential therapies aimed at compensating for the loss of intrinsically photosensitive retinal ganglion cells caused by glaucoma, Dr. Liu said. This might include therapies that alter light information signals involving the ​light-sensitive ​pigment melanopsin, such as a specific kind of light therapy or a new drug.​​​

​​​As Drs. Liu and Provencio work toward a solution; their research is also raising awareness about glaucoma's impact on sleep and mood.​​

​​"Our research will contribute to our understanding of the neural pathways underlying mood and behavioral changes experienced by glaucoma patients," she said. "Such insights are crucial for enhancing patient care and developing better treatments as glaucoma advances and evolves."​

Drs. Liu and Provencio Thank National Glaucoma Research Donors

Through the generosity of our donors, National Glaucoma Research, a BrightFocus Foundation program, is funding 38 innovative research studies around the world investigating the causes and potential prevention strategies, treatments, and a cure for glaucoma. Explore the research.

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