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7-keto Cholesterol is a bioactive sterol and a major oxysterol component of oxidized LDL.[1] [2]  It is produced by oxidation of cholesterol via ethanol-mediated lipid peroxidation or photodamage as well as oxidation of 7-dehydro cholesterol by the cytochrome P450 (CYP) isoform CYP7A1. [3][4][5] 7-keto Cholesterol inhibits CYP7A1 (IC50 = ~1 μM).[4]  It induces activation and chemotaxis of retinal microglia as well as polarization to a pro-inflammatory state via NLRP3 inflammasome activation in vitro.[6]  Intraocular implantation of 7-keto cholesterol coated wafers increases ocular levels of VEGF, IL-1β, and GRO/KC, macrophage infiltration, and neovascularization in rat eye. [7] Levels of 7-keto cholesterol in lipid deposits are increased in a variety of chronic diseases, including atherosclerosis, Alzheimer’s disease, and age-related macular degeneration.

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