Retinal Focus on Relationships between Diet-Induced, Advanced Glycation End Products and Supplemental Estradiol

Neurodegeneration of retinal tissue leads to progressive vision loss in millions of working-age adults each year. Metabolic alterations caused by modern diets that are high in fats and sugars contribute to the development of diabetic retinopathy. Chronic, diet-induced metabolic changes are linked to high glucose and harmful, pro-inflammatory compounds in the blood, called advanced glycation end products (AGEs), that can alter the integrity of neurovascular barriers. AGEs-induced changes to the permeability of the inner blood-retinal barrier can lead to progressive vision loss with disparate impacts in patients with low estrogen, such as via natural aging processes, chronic illness, or aggressive medical interventions. Application of supplemental estradiol has been shown to ameliorate degeneration across the cardiovascular, intestinal, and nervous systems. This commentary describes the potential benefits of estradiol-based therapies on the visual health of older women with progressive diabetic retinopathy.