"The Diseases of the Horny-coat of The Eye", known today as keratoconus, is a progressive, multifactorial, non-inflammatory ectatic corneal disorder that is characterized by steepening (bulging) and thinning of the cornea, irregular astigmatism, myopia, and scarring that can cause devastating vision loss. The significant socioeconomic impact of the disease is immeasurable, as patients with keratoconus can have difficulties securing certain jobs or even joining the military. Despite the introduction of corneal crosslinking and improvements in scleral contact lens designs, corneal transplants remain the main surgical intervention for treating keratoconus refractory to medical therapy and visual rehabilitation. To-date, the etiology and pathogenesis of keratoconus remains unclear. Research studies have increased exponentially over the years, highlighting the clinical significance and international interest in this disease. Hormonal imbalances have been linked to keratoconus, both clinically and experimentally, with both sexes affected. However, it is unclear how (molecular/cellular signaling) or when (age/disease stage(s)) those hormones affect the keratoconic cornea. Previous studies have categorized the human cornea as an extragonadal tissue, showing modulation of the gonadotropins, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Studies herein provide new data (both in vitro and in vivo) to further delineate the role of hormones/gonadotropins in the keratoconus pathobiology, and propose the existence of a new axis named the Hypothalamic-Pituitary-Adrenal-Corneal (HPAC) axis.

“眼角质层疾病”，今天称为圆锥角膜，是一种进行性、多因素、非炎症性角膜扩张疾病，其特征是角膜变陡（隆起）和变薄、不规则散光、近视和疤痕会导致毁灭性的视力丧失。这种疾病对社会经济的重大影响是无法估量的，因为圆锥角膜患者可能难以找到某些工作，甚至难以参军。尽管引入了角膜交联技术并改进了巩膜接触镜的设计，但角膜移植仍然是治疗药物治疗和视力康复难治性圆锥角膜的主要手术干预方式。迄今为止，圆锥角膜的病因和发病机制仍不清楚。这些年来，研究呈指数级增长，突出了这种疾病的临床意义和国际关注。荷尔蒙失调与圆锥角膜有关，无论是在临床上还是在实验上，两性都会受到影响。然而，尚不清楚这些激素如何（分子/细胞信号）或何时（年龄/疾病阶段）影响圆锥角膜。以前的研究将人类角膜归类为性腺外组织，显示出促性腺激素的调节，特别是黄体生成素 (LH) 和卵泡刺激素 (FSH)。本文的研究提供了新数据（两者 目前尚不清楚这些激素如何（分子/细胞信号）或何时（年龄/疾病阶段）影响圆锥角膜。以前的研究将人类角膜归类为性腺外组织，显示出促性腺激素的调节，特别是黄体生成素 (LH) 和卵泡刺激素 (FSH)。本文的研究提供了新数据（两者 目前尚不清楚这些激素如何（分子/细胞信号）或何时（年龄/疾病阶段）影响圆锥角膜。以前的研究将人类角膜归类为性腺外组织，显示出促性腺激素的调节，特别是黄体生成素 (LH) 和卵泡刺激素 (FSH)。本文的研究提供了新数据（两者在体外和体内）以进一步描述激素/促性腺激素在圆锥角膜病理学中的作用，并提出存在一个名为下丘脑-垂体-肾上腺-角膜 (HPAC) 轴的新轴。