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

Abstract 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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Potential Effects of Angiogenesis-related Factors on the Severity of APAC and Surgical Outcomes of Trabeculectomy

10.21203/rs.3.rs-129924/v1 ◽

2020 ◽

Author(s):

Jing Wang ◽

Ming-shui Fu ◽

Min-wen Zhou ◽

Bilian Ke ◽

Zhihua Zhang ◽

...

Keyword(s):

Success Rate ◽

Aqueous Humor ◽

Hypoxic Condition ◽

Angle Closure ◽

Related Factors ◽

Acute Primary Angle Closure ◽

Failure Group ◽

Primary Angle Closure ◽

Survival Plot

Abstract Background. Acute primary angle closure (APAC) caused by an abrupt closure of trabecular meshwork can develop into angle closure glaucoma due to uncontrolled IOP. Under reduced oxygen tension, hypoxia inducible transcription factors will be accumulated. EPO (erythropoietin) and PDGF (platelet derived growth factor) families are thought to be associated with angiogenesis under hypoxic condition.Methods. Concentrations of EPO, PDGF-AA, -BB, -CC and -DD collected in aqueous humor samples were measured. Before operations, correlations between target proteins and IOP 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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Efficacy of Brinzolamide in the Initial Management of Acute Primary Angle Closure in Chinese: a Randomized Controlled Trial

10.21203/rs.3.rs-230155/v1 ◽

2021 ◽

Author(s):

guang chen ◽

Xinming Peng ◽

Jun Li ◽

Peng Chen ◽

Jing Wang

Keyword(s):

Intraocular Pressure ◽

Success Rate ◽

Treatment Time ◽

Controlled Trial ◽

Sequential Treatment ◽

Angle Closure ◽

First Episode ◽

Initial Management ◽

Acute Primary Angle Closure ◽

Primary Angle Closure

Abstract Objective: Since comprehensive medication has an important role in the initial management of patients presenting with acute primary angle closure, it is necessary to analyze the effect of each drug on alleviating the disease. This study aimed to evaluate the intraocular pressure-lowering effect of brinzolamide in the sequential treatment of acute primary angle closure. Methods: In this randomized double-blind controlled trial, a total of 131 eyes of 125 consecutive patients who presented with their ﬁrst episode of acute primary angle closure were recruited and received sequential treatment. The patients were randomized to receive either brinzolamide or normal saline as a placebo. The primary outcomes were decreased intraocular pressure, success rate, and treatment time. Results: There was no statistically significant difference in the decreased level of intraocular pressure between the two groups at 6, 12, or 24 hours after the start of treatment (P-values were 0.526, 0.206, and 0.130, respectively). The success rate and treatment time were also not significantly different between the groups. No adverse side effects of brinzolamide were observed in the brinzolamide group. Conclusions: In patients with a first episode of acute primary angle closure, brinzolamide did not improve the effectiveness of the sequential treatment for reducing the intraocular pressure levels or shortening the treatment time within the ﬁrst 24 hours of initiating therapy.

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