Matricellular Protein Levels in Aqueous Humor and Surgical Outcomes of Trabeculectomy

Zhang, Zhihua; Miao, Yi; Wang, Jing; Zhou, Minwen; Fu, Mingshui; Wang, Ying

doi:10.1167/iovs.18-24534

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…Glaucoma surgery serves as a last-resort intervention for patients with uncontrolled IOP. The current study indicated that PSS patients have a higher risk of fibrosis due to the presence of proinflammatory cytokines after trabeculectomy [ 25 , 26 ]. However, in our study, the PSS patients with uncontrolled IOP who received compound trabeculectomy during the attack phase achieved well-controlled postoperative IOP and functional filter blebs.…”

Section: Discussionmentioning

confidence: 99%

Clinical Differences between Posner-Schlossman Syndrome Patients with Intermittent Intraocular Pressure Elevation and Glaucomatous Damage

Wang,

Zeng,

Zeng

et al. 2023

Ophthalmic Res

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Introduction: Although there is abundant evidence that Posner-Schlossman syndrome (PSS) can lead to secondary glaucoma, data on the clinical differences between PSS patients with secondary glaucoma and those with intermittent intraocular pressure (IOP) elevation are sparse. Methods: This retrospective observational study included 52 patients (52 eyes) diagnosed with PSS and admitted to Zhongnan Hospital of Wuhan University between January 2019 and February 2022. Demographic characteristics and clinical features were gathered from admission records. Patients were divided into two groups: 27 cases with intermittent IOP elevation (group A) and 25 cases with secondary glaucoma (group B and C). Of the secondary glaucoma cases, 18 were further divided into the topical IOP-lowering medications group (group B) and 7 into the glaucoma surgery group (group C). Clinical characteristics of different groups were compared. Results: Compared to the intermittent IOP elevation group, PSS patients with secondary glaucoma had a longer course of disease, a higher incidence of iris depigmentation, lower best corrected visual acuity, lower endothelial cell density, and higher interferon-γ (IFN-γ) concentration and cytomegalovirus (CMV) deoxyribonucleic acid (DNA) copy number in the aqueous humor (all p < 0.05). Group C presented a higher CMV DNA copy number in the aqueous humor than groups A and B (p < 0.05). Compound trabeculectomy proved effective in group C, with a functional filter bleb and well-controlled IOP without disease progression after 1 year of follow-up. Conclusion: Distinctive characteristics existed between PSS patients with secondary glaucoma and those with intermittent IOP elevation. Compound trabeculectomy appears to be an effective treatment option when IOP cannot be controlled through topical medications.

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Section: Discussionmentioning

confidence: 99%

Clinical Differences between Posner-Schlossman Syndrome Patients with Intermittent Intraocular Pressure Elevation and Glaucomatous Damage

Wang,

Zeng,

Zeng

et al. 2023

Ophthalmic Res

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“…The two likely mechanisms involved in late surgical failure include the presence of proinflammatory cytokines and fibrosis at the surgical site. [19][20][21][22] Previous studies have shown high levels of proinflammatory Figure 3 Cumulative probability of reoperation for IOP control was greater in the trabeculectomy group compared with the GDD group (P < 0.001, Log rank test). Two eyes had reoperation in eyes with PUC; however, 16 eyes underwent reoperation without PUC.…”

Section: Discussionmentioning

confidence: 99%

“…26 These proinflammatory cytokines are thought to lead to a slow remodeling of extracellular matrix over time leading to a higher risk of surgical failure. 19 In previous studies 9,[27][28][29] which evaluated the success of GDD in UG, different courses of uveitis management were used (Table 4). Factors like preoperative initiation of anti-inflammatory agents, route of medications administered, dosage regimen and duration of perioperative treatment were variable.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Perioperative Uveitis Control on the Success of Glaucoma Surgery in Uveitic Glaucoma

Magliyah

Badawi

Alshamrani

et al. 2021

OPTH

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Purpose To study the effects of perioperative uveitis control (PUC) on postoperative intraocular pressure (IOP) and uveitis activity in uveitic glaucoma (UG) patients who required glaucoma surgeries. Patients and Methods A retrospective chart review of 109 patients (120 eyes) which had glaucoma surgery for UG. A total of 66 eyes which had PUC were compared to 54 eyes which did not have. Measurements of IOP and uveitis activity were recorded preoperatively and over 2 years postoperatively. Average number of antiglaucoma medications and frequency of surgical failure were obtained in both groups. Results Over 2 years postoperatively, average IOP was lower in eyes which had PUC. Significant differences in IOP were found at 3 months (P = 0.004), 6 months (P = 0.001), 1 year (P < 0.001), and 2 years (P < 0.001). Lower grades of anterior chamber (AC) inflammation were found in eyes which had PUC. Significant differences were found at 1 month (P < 0.001), 3 months (P < 0.001) and 6 months (P = 0.001). Mean number of antiglaucoma medications at last visit was 0.7 ± 1.1 for eyes which had PUC and 2.6 ± 1.5 for eyes which did not have PUC (P < 0.001). Among eyes which had PUC, only two eyes required second glaucoma surgeries, while 16 eyes with no PUC required further glaucoma surgeries after 27.7 ± 12.5 months (P < 0.001). Conclusion Proper PUC in patients going for UG surgeries results in lower IOP levels and less AC inflammation over 2 years postoperatively. A comprehensive PUC regimen is needed for uveitic glaucoma patients going for surgeries.

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“…However, various factors in the aqueous humor were found rising during acute angle closure, such as matricellular proteins and inflammation factors. The former can cause the extracellular deposition of fibrillary and obstruct the outflow route [ 34 , 35 ], and the latter can cause the function loss of the blebs [ 5 ]. Therefore, we speculated that even though EPO was more elevated to protect the RGCs in severe cases, the level of EPO was not high enough to completely reverse the fibrosis, and it ultimately resulted in surgical failure.…”

Section: Discussionmentioning

confidence: 99%

Potential effects of angiogenesis-related factors on the severity of APAC and surgical outcomes of trabeculectomy

Wang

Zhou

et al. 2021

BMC Ophthalmol

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Background EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition. The sharp rise of intraocular pressure in acute primary angle closure (APAC) results in an inefficient supply of oxygen and nutrients. We aimed to measure the expression of EPO and PDGF family members in APAC eyes and demonstrate their associations with APAC’s surgical success rate. Methods Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples of 55 patients recruited were measured. Before operations, correlations between target proteins and IOP (intraocular pressure) were detected between APAC (acute primary angle closure) and cataract patients. Based on the post-operative follow-up, the effects of EPO and PDGF family members on the successful rate of trabeculectomy were tested. Results The levels of EPO, PDGF-CC and -DD were significantly elevated in the APAC group compared to the cataract group. During the post-operative follow-up, EPO, PDGF-CC and -DD showed significant differences between the success and failure groups. In multivariable linear regression analyses, failed filtration surgery was more likely in APAC eyes with higher EPO level. The Kaplan-Meier survival plot suggested that the success rate in eyes with low EPO level was significantly higher than that in eyes with high EPO level. Conclusion The levels of EPO, PDGF-CC and -DD were significantly elevated in failure group. EPO level correlated with preoperative IOP and numbers of eyedrops, and higher EPO level in aqueous humor is a risk factor for trabeculectomy failure. It can be a biomarker to estimate the severity of APAC and the success rate of surgery. The investigation of mechanism of EPO in APAC a may have potential clinical applications for the surgical treatment of APAC.

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Matricellular Protein Levels in Aqueous Humor and Surgical Outcomes of Trabeculectomy

Abstract: In previous APAC patients, the SPARC level in aqueous humor is a prognostic factor for surgical results of trabeculectomy. Modulation of SPARC expression may have potential clinical applications after filtration surgery.

Cited by 10 publications

References 22 publications

Clinical Differences between Posner-Schlossman Syndrome Patients with Intermittent Intraocular Pressure Elevation and Glaucomatous Damage

Clinical Differences between Posner-Schlossman Syndrome Patients with Intermittent Intraocular Pressure Elevation and Glaucomatous Damage

The Effect of Perioperative Uveitis Control on the Success of Glaucoma Surgery in Uveitic Glaucoma

Potential effects of angiogenesis-related factors on the severity of APAC and surgical outcomes of trabeculectomy

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