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Protecting the aging eye with hydrogen sulfide.

Research demonstrates that senescence is associated with tissue and organ dysfunction, and the eye is no exception. Sequelae arising from aging have been well-defined as distinct clinical entities and vision-impairment has significant psychosocial consequences. Retina and adjacent tissues like retinal pigmented epithelium (RPE) and choroid are the key structures that are required for visual perception. Any structural and functional changes in retinal layers and blood retinal barrier (BRB) could lead to age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma. Further, there are significant oxygen gradients in eye that can lead to excessive reactive oxygen species (ROS) resulting in endoplasmic reticulum (ER) and mitochondrial stress response. These radicals are source of functional and morphological impairment in RPE, and retinal ganglion cells (RGCs). Therefore, ocular diseases could be summarized as disturbance in the redox homeostasis. Hyperhomocysteinemia (HHcy) is a risk factor and causes vascular occlusive disease of the retina. Interestingly, hydrogen sulfide (H2S) has been proven to be an effective antioxidant agent, and it can help treat diseases by alleviating stress and inflammation. Concurrent glutamate excitotoxicity, ER stress, and microglia activation are also linked to stress, thus H2S may offer additional interventional strategy. A refined understanding of the aging eye along with H2S biology, and pharmacology may help guide newer therapies for the eye.