Aim: This review article presents a comprehensive overview of the literature on
sex hormones (
estrogens,
androgens,
progesterone) and optic nerve disorders, with a discussion of the implications for
therapy and prevention. Methods: Epidemiological, pre-clinical and clinical studies were reviewed. Results: Analysis of the
biological basis for a relationship between
eye diseases and
sex hormones showed that some types of
hormones can exert a protective effect either directly on the retina and optic nerve or indirectly by modulating ocular blood flow. For example, it seems that
estrogen exposure has a protective effect against
glaucoma, whereas its deficit may lead to early onset of the disease. If further studies confirm the data in the literature,
estrogen therapy, because of its
antioxidant action, may be effective in the treatment of
Leber's hereditary optic neuropathy, whereas, in the light of current studies, there does not seem to be an influence of
estrogen on non-arteritic anterior ischemic
optic neuritis (
NAION). Conclusions: Although there is some evidence that in some optic nerve pathologies the
sex hormones seem to play an important role there are still too few studies providing evidence for its wider use in clinical practice.