Progesterone as a potential neuroprotective treatment in the retina

Abstract

Diseases and injuries that affect the eye and cause vision loss are a serious problem worldwide, both in terms of economic impact and patient quality of life. Few effective treatments currently exist to address this significant unmet need. The authors review research on progesterone treatment in traumatic brain injury and stroke showing that this pleiotropic hormone is a successful neuroprotective treatment in a variety of animal models. The authors also describe the ocular disorders that they think are the best candidates for progesterone treatment, other treatments currently available, research relevant to bringing progesterone treatment to the eye, including evidence of progesterone and its receptors in the eye,the overlap between mechanisms involved in retinal diseases and mechanisms modulated by progesterone and research on progesterone in the eye so far. Progesterone’s pleiotropic properties and its success in pre-clinical models of traumatic brain injury and stroke make it an attractive candidate as a therapy for some disorders affecting the retina. This review discusses progesterone as a potential neuroprotective treatment in the retina and optic nerve.

Keywords::

• eye
• neuroprotection
• neurosteroid
• progesterone
• retina

Acknowledgements

The authors gratefully acknowledge Leslie McCann and Dr Machelle Pardue for their help with the preparation of the manuscript.

Financial & competing interests disclosure

This review is based upon work supported by a generous gift from H. Allen and Company, Atlanta VA Rehab R&D Service of the Department of Veterans Affairs, The Abraham J. and Phyllis Katz Foundation, Foundation Fighting Blindness, Research to Prevent Blindness, NIH NEI R01EY014026, R01EY016470, R24EY017045, P30EY006360, and T32EY007092–27. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Progesterone enhances functional and morphological recovery in a number of preclinical central and peripheral nervous system injury models.

• Cerebral ischemic injuries, even minor ones, are often accompanied by visual function deficits.

• Neuroprotective treatments for traumatic and degenerative disorders of the retina are needed, and a pleiotropic hormone like progesterone may represent a novel approach.

• Progesterone can inhibit glial cell swelling in the eye and slow the loss of retinal and nerve fiber layers in laboratory animals.

• Progesterone, progesterone synthesis and progesterone receptors are observed in the retina, indicating that progesterone could be a good candidate for treatment of retinal disorders.

Notes