Abstract: Aldosterone, as an important mineralocorticoid secreted by the adrenal gland, is involved in various pathological and physiological processes such as systemic water and electrolyte balance, inflammation, and immunity. Inflammation, immune, and vascular related abnormalities in water and electrolyte balance are closely related to the occurrence and development of various eye diseases. Extensive research on cardiovascular diseases has confirmed that aldosterone can activate mineralocorticoid receptors and play a pro-inflammatory role in systemic diseases. Previous studies have suggested that aldosterone plays a beneficial anti-inflammatory role in inflammatory diseases such as uveitis, and its mechanism may be not only due to its activation of mineralocorticoid receptors, but also due to the disruption of corticosteroid receptor homeostasis under aldosterone application. Meanwhile, aldosterone plays a role in the ocular water and electrolyte balance, promoting exudative changes in diseases such as central serous retinopathy and wet age-related macular degeneration. Aldosterone also participates in aqueous humor homeostasis and nerve damage, and may play a key role in the pathological process of glaucoma. By further clarifying the regulatory mechanisms of systemic and local aldosterone on the physiological and pathological processes of the eye, new evidence may be provided for exploring the pathogenesis of related eye diseases, while also providing new diagnostic and therapeutic ideas for the development of new disease diagnosis and treatment methods. (Int Rev Ophthalmol, 2024, 48: 371-377)

Key words: aldosterone, water and electrolyte balance, inflammation, ocular diseases