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LIPID DISORDERS / STATE OF THE ART PAPER
Understanding the link between lipid and ocular disorders for effective therapy
1
Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia
2
Department of Biochemistry, Faculty of Medicine, Manipal University College, Malaysia
3
Optometry and Vision Science Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda, Abdul Aziz, Kuala Lumpur, Malaysia
These authors had equal contribution to this work
Submission date: 2025-10-09
Final revision date: 2025-12-24
Acceptance date: 2026-01-04
Online publication date: 2026-04-03
Corresponding author
Lidawani Lambuk
Optometry and Vision Science Programme Center for Community Health Studies (ReaCH) Faculty of Health Sciences Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz Kuala Lumpur, Malaysia
Optometry and Vision Science Programme Center for Community Health Studies (ReaCH) Faculty of Health Sciences Universiti Kebangsaan Malaysia Jalan Raja Muda Abdul Aziz Kuala Lumpur, Malaysia
KEYWORDS
TOPICS
ABSTRACT
Cholesterol is an essential lipid for cellular integrity and metabolic homeostasis; however, dysregulated cholesterol metabolism is increasingly recognized as a key contributor to multiple ocular diseases. Beyond its established role in cardiovascular pathology, emerging evidence implicates altered lipoprotein balance, impaired cholesterol transport, and lipid-driven inflammation in the pathogenesis of age-related macular degeneration, retinal vascular diseases, cataracts, and glaucoma. This review integrates current knowledge on cholesterol synthesis, transport, and regulation with ocular-specific mechanisms, emphasizing the differential roles of low-density lipoprotein, high-density lipoprotein, and triglyceride-rich lipoproteins. Key molecular pathways, including the mevalonate-SREBP axis, ABCA1/ABCG1-mediated reverse cholesterol transport, VEGF-driven angiogenesis, oxidative stress signaling, and inflammatory cascades, are critically discussed. Clinical and translational implications are highlighted, particularly the potential ocular benefits of lipid-modulating therapies such as statins, fenofibrate, and antioxidant supplementation. Understanding cholesterol as a modifiable determinant of ocular health may enable integrated preventive strategies and guide future therapeutic innovation in vision-threatening diseases.
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