Sergey A Dzugan
It is known that the retina is part of the central nervous system (CNS) and the retina is an authentic steroidogenic structure of the CNS. Steroids such as pregnenolone, DHEA, progesterone, testosterone and estrogens are neurosteroids. It has been shown in different studies that steroids may prevent neuronal cell death. Decreased levels of most steroids during aging make neurons more vulnerable to damage. A new hypothesis has been proposed that acquired errors of physiology, including steroidopenia, are the root cause of age-related macular degeneration (AMD). We hypothesized that the macula tries to increase the production of steroid hormones by increasing absorption of cholesterol, but it cannot, due to aging enzymatic failure. This leads to drusen formation and macular degeneration. Low hormones down regulate stem cell function, leading to an inability of stem cells to maintain optimal macular function and structure. Also, drusen development is possibly the body's attempt to repair micro-breaks in retinal pigment epithelium or Bruch's membrane. We analysed 53 patients with the dry form of AMD (26 male and 27 female). Our study showed that profound deficiencies existed in DHEA and pregnenolone in males and females, estrogens and progesterone in females and a moderate deficiency of testosterone in men and women and progesterone in men. All patients were treated by a multimodal program which included: hormonorestorative therapy with bio-identical hormones, vitamins, minerals and supplements. Our preliminary results showed an improvement in dark adaptation and stability of the macula, which we suspect is a direct stimulatory effect on the retinal pigment epithelium. We believe that AMD and diabetic retinopathy caused by severe aging, deterioration of neurological structures of the eyes and physiology optimization with the correction of steroidopenia may help to stop the progression of both conditions through direct effect on retina and through potentiation of stem cells function.