Abstract：
Glaucoma is a leading cause of irreversible blindness worldwide and is characterized by progressive loss of visual function and retinal ganglion cells (RGC). Current epidemiological, clinical, and basic science evidence suggest that estrogen plays a role in the aging of the optic nerve. Menopause, a major biological life event affecting all women, coincides with a decrease in circulating sex hormones, such as estrogen. While 59% of the glaucomatous population are females, sex is not considered a risk factor for developing glaucoma. In this review, we explore whether menopause is a sex-specific risk factor for glaucoma. First, we investigate how menopause is defined as a sex-specific risk factor for other pathologies, including cardiovascular disease, osteoarthritis, and bone health. Next, we discuss clinical evidence that highlights the potential role of menopause in glaucoma. We also highlight preclinical studies that demonstrate larger vision and RGC loss following surgical menopause and how estrogen is protective in models of RGC injury. Lastly, we explore how surgical menopause and estrogen signaling are related to risk factors associated with developing glaucoma (e.g., intraocular pressure, aqueous outflow resistance, and ocular biomechanics). We hypothesize that menopause potentially sets the stage to develop glaucoma and therefore is a sex-specific risk factor for this disease.
摘要：
青光眼是全球范围内不可逆失明的主要原因，其特征是视觉功能和视网膜神经节细胞（RGC）的进行性丧失。当前流行病学,临床,基础科学证据表明，雌激素在视神经老化中起作用。更年期,影响所有女性的重大生物事件，与循环性激素的减少相吻合，比如雌激素。虽然59%的青光眼患者是女性，性别不被认为是发生青光眼的危险因素.在这次审查中,我们探讨更年期是否是青光眼的性别特异性危险因素.首先,我们调查更年期如何定义为其他疾病的性别特异性危险因素，包括心血管疾病,骨关节炎,骨骼健康。接下来,我们讨论了强调更年期在青光眼中潜在作用的临床证据.我们还重点介绍了临床前研究，这些研究表明手术绝经后视力和RGC丧失以及雌激素在RGC损伤模型中的保护作用。最后,我们探讨手术绝经和雌激素信号与发展中的青光眼相关的危险因素(例如，眼内压,水流出阻力，和眼部生物力学)。我们假设更年期可能会导致青光眼的发展，因此是该疾病的性别特异性危险因素。
