Background
Increasing evidence suggests that both male and female sex hormones may be associated with the development of atherosclerosis, but almost all such data are based on studies of patients with coronary artery disease. To our knowledge, there are no data on the effects of endogenous sex hormones on atherosclerosis of the retinal arteries in men, and the purpose of this study was to explore that association.
Material and Method
In 101 consecutive adult male patients treated in a university hospital outpatient clinic, atherosclerotic changes of the retinal vessels were identified prospectively by direct ophthalmoscopy and were graded on a scale of 1 to 4 according to Scheie. Commercial radioimmunoassay kits were used to measure serum levels of testosterone, estradiol, progesterone, androstenedione, and dehydroepiandrosterone sulfate. The chi-square test was used to compare the results with those from 47 matched male subjects with healthy retinal vessels.
Results
Retinal vessel atherosclerosis was inversely correlated with the serum progesterone concentration (P<0.001). The lower the progesterone concentration, the more advanced the stage of retinal vessel disease. A similar but less statistically significant correlation was noticed for dehydroepiandrosterone sulfate (P<0.05). A weak (P<0.05) similar association between the degree of retinal artery atherosclerosis and estradiol levels was also found.
Conclusions
Low endogenous progesterone levels and, to a degree, low dehydroepiandrosterone sulfate and estradiol levels might be associated with atherosclerosis of the retinal arteries in men.

Keywords: Gonadal Steroid Hormones - physiology, Atherosclerosis - physiopathology, Retinal Artery - physiopathology