To compare aqueous humor vascular endothelial growth factor (VEGF) levels in diabetic patients with acute primary angle closure (APAC) and evaluate the relationship between VEGF concentrations and surgical outcomes following filtration surgery.
Approach:
Study Design: A prospective study involving 46 eyes of diabetic individuals with a history of APAC, assessing aqueous humor VEGF levels and surgical outcomes.
Surgical Procedure: All eyes underwent combined phacoemulsification, intraocular lens (IOL) implantation, and trabeculectomy, followed by follow-up examinations at various intervals.
Data Analysis: VEGF levels were analyzed in relation to surgical success and bleb morphology, using both univariate and multivariate analyses.
Key Findings:
Aqueous VEGF concentrations were significantly higher in the surgical failure group (P = 0.0018).
Higher VEGF levels were associated with surgical failure (univariate: P = 0.021, OR = 9.826; multivariate: P = 0.030, OR = 8.542).
The low-VEGF group had a significantly higher success rate compared to the high-VEGF group (overall success: P = 0.0276; complete success: P = 0.0073).
VEGF levels positively correlated with bleb scores (Spearman's ρ = 0.6840, P < 0.0001).
Interpretation:
Higher aqueous humor VEGF levels in diabetic patients with APAC are associated with less favorable outcomes following filtration surgery, suggesting VEGF may be a potential marker for surgical success.
Limitations:
The study involved a small cohort, limiting the generalizability of the findings.
Further external validation in larger prospective cohorts is needed to confirm these results.
Conclusion:
Higher aqueous humor VEGF levels are linked to poorer filtration surgery outcomes in diabetic patients with APAC.
