Aqueous Humor sCD44 concentration and visual field loss in primary open-angle glaucoma

Purpose: To correlate aqueous humor soluble CD44 (sCD44) concentration, visual field loss, and glaucoma risk factors in primary open-angle glaucoma (POAG) patients, Methods: Aqueous samples were obtained by paracentesis from normal and glaucoma patients who were undergoing elective surgery and analyzed for sCD44 concentration by enzyme-linked immunosorbent assay. Results: In normal aqueous (n 124) the sCD44 concentration was 5.88 +/- 1 0.27 ng/mL, whereas in POAG aqueous (n = 90) the sCD44 concentration was 12.76 +/- 0.66 ng/mL, a 2.2-fold increase (P < 0.000001). In POAG patients with prior successful filtration surgery (n = 13), the sCD44 concentration was decreased by 43% to 7.32 +/- 1.44 (P = 0.001) in comparison with POAG patients without filtration surgery; however, the sCD44 concentration in the prior successful filtration subgroup with no medications and normal intraocular pressure was 12.62 +/- 3.81 (P = 0.05) compared with normal. The sCD44 concentration of normal pressure glaucoma patients was 9.19 +/- 1.75 ng/mL, a 1.6-fold increase compared with normal (P = 0.02). Race and intraocular pressure pulse amplitude were significant POAG risk factors in this cohort of patients. In both normal and POAG patients with mild and moderate visual field loss, sCD44 concentration was greater in African Americans than in whites (P = 0.04) Conclusions: sCD44 concentration in the aqueous of POAG patients correlated with the severity of visual field loss in all stages in white patients and in mild to moderate stages in African American patients. sCD44 concentration in aqueous is a possible protein biomarker of visual field loss in POAG.