Girl Power in Glaucoma: The Role of Estrogen in Primary Open Angle Glaucoma

• Published in: Cellular and molecular neurobiology Vol. 42; no. 1; pp. 41 - 57
• Main Authors: Fotesko, Kyrylo, Thomsen, Bo Schneider Vohra, Kolko, Miriam, Vohra, Rupali
• Format: Journal Article
• Language: English
• Published: New York Springer US 2022; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Blindness; Cell Biology; Epidemiology; Estrogens; Female; Glaucoma; Glaucoma - drug therapy; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - drug therapy; Hormone replacement therapy; Humans; Menopause; Neurobiology; Neurodegeneration; Neurodegenerative diseases; Neurosciences; Optic nerve; Post-menopause; Quality of Life; Retina; Retinal Ganglion Cells; Review Paper; Glaucoma; Neuroprotection; Menopause; Estrogen
• ISSN: 0272-4340; 1573-6830
• DOI: 10.1007/s10571-020-00965-5

Estrogen is essential in maintaining various physiological features in women, and a decline in estrogen levels are known to give rise to numerous unfortunate symptoms associated with menopause. To alleviate these symptoms hormone replacement therapy with estrogen is often used, and has been shown to be fruitful in improving quality of life in women suffering from postmenopausal discomforts. An often forgotten condition associated with menopause is the optic nerve disorder, glaucoma. Thus, estrogen may also have an impact in maintaining the retinal ganglion cells (RGCs), which make up the optic nerve, thereby preventing glaucomatous neurodegeneration. This review aims to provide an overview of possible associations of estrogen and the glaucoma subtype, primary open-angle glaucoma (POAG), by evaluating the current literature through a PubMed-based literature search. Multiple in vitro and in vivo studies of RGC protection, as well as clinical and epidemiological data concerning the well-defined retinal neurodegenerative disorder POAG have been reviewed. Over all, deficiencies in retinal estrogen may potentially instigate RGC loss, visual disability, and eventual blindness. Estrogen replacement therapy may therefore be a beneficial future treatment. However, more studies are needed to confirm the relevance of estrogen in glaucoma prevention.