Estrogen deficiency accelerates aging of the optic nerve

Abstract

Objective To provide a comprehensive review on hormone-based pathophysiology of aging of the optic nerve and glaucoma. Methods A literature review and expert opinions. Results Glaucoma, a group of intraocular pressure-related optic neuropathies, is characterized by the slow progressive neurodegeneration of retinal ganglion cells and their axons resulting in irreversible visual sensitivity loss and blindness. Increasing evidence suggests that glaucoma represents the accelerated aging of the optic nerve and is a neurodegenerative disease of the central nervous system. This review highlights the high burden of glaucoma in elderly women and the importance of understanding the hormone-related pathophysiology of optic nerve aging and glaucoma in women. Conclusions Strong epidemiological, clinical, and experimental evidence supports the proposed hypothesis that the early loss of estrogen leads to premature aging and increased susceptibility of the optic nerve to glaucomatous damage. Future investigations into the hormone-related mechanisms of aging and glaucoma will support the development of novel sex-specific preventive and therapeutic strategies in glaucoma.

The estrogenic retina: The potential contribution to healthy aging and age-related neurodegenerative diseases of the retina

“…It is unknown the real contribution of circulating steroids in the retinal local synthesis, if the local E2 production may be regulated by circulating levels like it is suggested for other extragonadal organs including the brain [15,41], thus if local levels are high when plasma levels are low. Changes in circulating levels have been suggested to influence retinal/ocular diseases; oestrogen deficiency has showed to accelerate aging of the optic nerve [147]. The exact E2 physiological role and ERs' molecular mechanisms are still elusive.…”

There is more to the relation between intraocular pressure and metabolic syndrome than meets the eye

“…16 Furthermore, postmenopausal hormone (PMH) use was associated with a reduced risk of high-tension POAG in the Nurses Health Study. 17 For more details regarding the critical role of estrogen in POAG pathogenesis, see a recent review by Vajarant and Pasquale 18 in Menopause.…”

Complex trait genetics: mapping, correlation and causation

“…Another interesting result in this study was the one supporting genetic differences between female and male POAG. Research has shown evidence that estrogen has protective effects against POAG potentially by promoting higher production of collagen fibers that increase flexibility of the eye, thus reducing IOP [164][165][166]. This could explain our findings given that genetic variation in the estrogen pathways may have a higher impact in women than in men.…”

“…POAG heritability) was still unknown. Further, epidemiological studies indicate that higher estrogen levels may help prevent POAG [164][165][166] and that the prevalence of POAG differs between sexes (the prevalence in men is higher than in women). Therefore, using genotype data of Australian cases and controls, we investigate the contribution of common and rare variants to POAG and we assess whether there are differences between POAG sexes (generated by genetic variants acting in men but not women, or vice versa).…”