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Biomarkers to Predict Glaucoma Surgical Success

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Surgical Innovations in Glaucoma

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Abstract

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.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 150 East Huron, Suite 1000, Chicago, IL, 60611, USA

    Paul A. Knepper MD, PhD

  2. Department of Ophthalmology, Northwestern University Medical School, Chicago, IL, USA

    Paul A. Knepper MD, PhD

  3. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 West Taylor Street Building 902 Room B1, Chicago, IL, 60612, USA

    Algis Grybauskas & Paulius V. Kuprys

  4. Department of Ophthalmology and Visual Sciences, University of Illinois, 1855 West Taylor Street Building 902 Room B1, Chicago, IL, 60612, USA

    Kevin Skuran

  5. Department of Surgery, Rocky Vista University, Parker, CO, USA

    John R. Samples MD

  6. Western Glaucoma Foundation, Portland, OR, USA

    John R. Samples MD

  7. Cornea Consultants of Colorado, Littleton, CO, USA

    John R. Samples MD

  8. The Eye Clinic, Portland, OR, USA

    John R. Samples MD

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  1. Paul A. Knepper MD, PhD
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  2. Algis Grybauskas
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  3. Paulius V. Kuprys
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  4. Kevin Skuran
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  5. John R. Samples MD
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Corresponding author

Correspondence to Paul A. Knepper MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery, Rocky Vista University, Parker, CO, USA

    John R. Samples MD

  2. Western Glaucoma Foundation, Portland, OR, USA

    John R. Samples MD

  3. Cornea Consultants of Colorado, Littleton, CO, USA

    John R. Samples MD

  4. The Eye Clinic, Portland, OR, USA

    John R. Samples MD

  5. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Iqbal Ike K. Ahmed MD, FRCSC

Electronic supplementary material

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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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Knepper, P.A., Grybauskas, A., Kuprys, P.V., Skuran, K., Samples, J.R. (2014). Biomarkers to Predict Glaucoma Surgical Success. In: Samples, J.R., Ahmed, I.I.K. (eds) Surgical Innovations in Glaucoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8348-9_27

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