Matricellular Protein Levels in Aqueous Humor and Surgical Outcomes of Trabeculectomy.
Zhang Zhihua, Miao Yuyu, Wang Jing, Zhou Minwen, Fu Mingshui, Wang Ying
AI Summary
Aqueous humor SPARC levels in APAC patients predict trabeculectomy success, with higher SPARC correlating to failure. Modulating SPARC could improve surgical outcomes.
Abstract
Purpose
The purpose of this study was to quantify levels of three matricellular proteins in the aqueous humor in patients with previous acute primary angle closure (APAC) and investigate their correlation with bleb morphology and surgical outcomes of trabeculectomy.
Methods
In this prospective study, aqueous humor samples were collected from 40 previous APAC eyes. Concentrations of three matricellular proteins-secreted protein acidic and rich in cysteine (SPARC), thrombospondin-2, and osteopontin-were measured using multiplexed immunoassays kits. Intraocular pressure was measured using Goldmann application tonometry. Bleb morphology was assessed using anterior segment optical coherence tomography, and bleb score was calculated according to bleb size and reflectivity.
Results
When previous APAC eyes were divided according to surgical outcome 18 months after trabeculectomy, SPARC protein was significantly higher in aqueous humor in the failure group (P = 0.009). When previous APAC eyes were divided according to SPARC level, eyes with low SPARC levels had significantly higher overall success rate compared with eyes with high SPARC levels (P = 0.005 for complete success and P = 0.018 for qualified success). Multiple logistic regression analyses showed that eyes with higher levels of SPARC were more likely to have a failed filtration surgery than were eyes with lower levels of SPARC. For complete success, P = 0.006 and odds ratio (OR) = 6.458; for qualified success, P = 0.033 and OR = 2.608. The level of SPARC was found to have a positive correlation with bleb score (P < 0.001, R2 = 0.471).
Conclusions
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.
MeSH Terms
Shields Classification
Key Concepts5
In patients with previous acute primary angle closure (APAC), SPARC protein was significantly higher in aqueous humor in the trabeculectomy failure group (P = 0.009) compared to the success group 18 months after trabeculectomy.
In patients with previous acute primary angle closure (APAC) undergoing trabeculectomy, eyes with low SPARC levels had a significantly higher overall success rate compared with eyes with high SPARC levels (P = 0.005 for complete success and P = 0.018 for qualified success).
Multiple logistic regression analyses showed that eyes with higher levels of SPARC in aqueous humor were more likely to have a failed filtration surgery than were eyes with lower levels of SPARC in patients with previous acute primary angle closure (APAC) undergoing trabeculectomy (for complete success, P = 0.006 and odds ratio (OR) = 6.458; for qualified success, P = 0.033 and OR = 2.608).
The level of SPARC in aqueous humor was found to have a positive correlation with bleb score (P < 0.001, R2 = 0.471) in patients with previous acute primary angle closure (APAC) who underwent trabeculectomy.
In patients with previous acute primary angle closure (APAC), the SPARC level in aqueous humor is a prognostic factor for surgical results of trabeculectomy.
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