Aqueous Humor Vascular Endothelial Growth Factor in Patients with Primary Open Angle Glaucoma, a review article

Background: Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness, with vascular endothelial growth factor (VEGF) and its soluble receptors (sVEGFR1, sVEGFR2) implicated in disease pathogenesis. This study aims to evaluate aqueous humor (AH) titres of VEGF, sVEGFR1, and sVEGFR2 in POAG patients and assess their diagnostic performance. Methods: This cross-sectional study included 120 adults undergoing anterior segment surgery: 40 controls, 40 medically controlled POAG, and 40 non–medically controlled POAG patients. All underwent ophthalmic examination, intraocular pressure (IOP) measurement, and AH sampling for VEGF, sVEGFR1, and sVEGFR2 quantification via ELISA. Results: IOP was significantly higher in non-controlled POAG (26.47 ± 5.34 mmHg) as opposed to controlled POAG (16.25 ± 2.46 mmHg) and controls (16.47 ± 2.59 mmHg) (P < 0.001). VEGF titres were diminished in non-controlled POAG (10.59 ± 1.8 pg/mL) as opposed to controlled POAG (21.05 ± 2.55 pg/mL) and controls (18.91 ± 2.68 pg/mL) (P < 0.001), while sVEGFR1 and sVEGFR2 were elevated in POAG groups (P < 0.001). In non-controlled POAG, VEGF correlated negatively with IOP (r = −0.724, P < 0.001), whereas sVEGFR1 (r = 0.451, P < 0.001) and sVEGFR2 (r = 0.672, P < 0.001) correlated positively. The combined VEGF, sVEGFR1, and sVEGFR2 panel achieved 93.8% sensitivity, 60% specificity, AUC = 0.897, and 82.5% accuracy for POAG detection. Conclusions: AH VEGF, sVEGFR1, and sVEGFR2 are significantly altered in POAG, with combined measurement showing strong diagnostic potential. These biomarkers may aid in diagnosis and understanding of POAG pathogenesis.