We read with great interest the recent article by Zhou et al. [1]. They demonstrate, through systematic review and metanalysis, the patients with short sleep duration (<6 h) are at an elevated risk of Age-related Macular Degeneration (AMD). We would like to extend this discussion and encourage conversation around the hypothesis that the association between AMD and sleep disruption may, in some instances, occur in conjunction with underlying neurodegenerative disease (NDD).

The relationship between sleep and AMD appears to be one of significance in patients afflicted with sleep-depriving illness. The majority of the literature refers to sleep and AMD relationship in the presence of a sleep-limiting disease, such as sleep apnoea or insomnia. Further, the observation that correction of the sleep-wake cycle with prescription melatonin truncates AMD progression would support sleep’s direct pathophysiological influence in AMD [2].

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