Biomarkers to Predict Glaucoma Surgical Success

  • Paul A. KnepperEmail author
  • Algis Grybauskas
  • Paulius V. Kuprys
  • Kevin Skuran
  • John R. Samples


Primary open-angle glaucoma (POAG) is a primary neuronal disease of the optic nerve without a definable cause which may require surgical intervention to prevent further visual loss and/or normalize intraocular pressure. Worldwide, POAG is the second leading cause of blindness; there are 45 million people today with POAG and bilateral blindness is present in 4.5 million people. We cataloged all known ocular biomarkers in the aqueous humor, trabecular meshwork, optic nerve, as well as systemic biomarkers in blood serum/plasma into four categories, namely, extracellular matrix (ECM), cell signaling molecules, aging/stress, and immunity-related changes. We present a theoretical model to show signaling pathways of the ECM, cell signaling, and innate immune response through activation of Toll-4 receptor and monocyte activation which may impact the success of glaucoma surgery. The innate immune system is driven by the danger signal, the low molecular weight hyaluronic acid, and the activation of monocytes which collectively may be useful in predicting surgical success in POAG.


Hyaluronic Acid Aqueous Humor Trabecular Meshwork Visual Field Loss Monocyte Activation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 27.1

Nail fold hemorrhages in a 74-year-old low-tension POAG patient who has had successful filtration surgery and stable visual fields. Video capillaroscopy was performed using a JH-1004 capillaroscope at 280× magnification. Note the two nail fold hemorrhages indicated by flashing white arrows (AVI 208582 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Paul A. Knepper
    • 1
    • 2
    Email author
  • Algis Grybauskas
    • 3
  • Paulius V. Kuprys
    • 3
  • Kevin Skuran
    • 4
  • John R. Samples
    • 5
    • 6
    • 7
    • 8
  1. 1.Department of Ophthalmology and Visual SciencesUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of OphthalmologyNorthwestern University Medical SchoolChicagoUSA
  3. 3.Department of Ophthalmology and Visual SciencesUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Department of Ophthalmology and Visual SciencesUniversity of IllinoisChicagoUSA
  5. 5.Department of SurgeryRocky Vista UniversityParkerUSA
  6. 6.Western Glaucoma FoundationPortlandUSA
  7. 7.Cornea Consultants of ColoradoLittletonUSA
  8. 8.The Eye ClinicPortlandUSA

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