Role of aqueous humor matrix metalloproteinase-3 in the differential diagnosis of glaucoma subtypes

doi:10.3969/j.issn.1673-8640.2026.07.001

Abstract

Abstract:

Objective To investigate the differences in aqueous humor matrix metalloproteinase（MMP）-3 levels among different subtypes of glaucoma patients and its value in the differential diagnosis of primary open-angle glaucoma（POAG）and Posner-Schlossman syndrome（PSS）. Methods A total of 100 glaucoma patients from Eye & ENT Hospital of Fudan University from January 2024 to June 2025 were enrolled，including 37 cases of PSS（PSS group），32 cases of POAG（POAG group） and 31 cases of angle-closure glaucoma （ACG）（ACG group），with 25 cases of age-related cataract（ARC）as control group. The intraocular pressure and aqueous humor MMP-3 levels were determined. Spearman correlation analysis was used to evaluate the correlation between aqueous humor MMP-3 levels and intraocular pressure. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of aqueous humor MMP-3 in differentiating PSS and POAG. Results The aqueous humor MMP-3 levels in PSS group and ACG group were higher than those in control group and POAG group（P<0.000 1），and there was no statistical significance between PSS group and ACG group（P>0.05）. There was no correlation between aqueous humor MMP-3 levels and intraocular pressure in PSS group，POAG group and ACG group（r values were -0.125，0.271 and 0.180，respectively，P>0.05）. The area under curve（AUC）for aqueous humor MMP-3 in differentiating PSS and POAG was 0.821. Conclusions Aqueous humor MMP-3 can be a biomarker for differentiating PSS and POAG.

Key words: Matrix metalloproteinase-3, Aqueous humor, Glaucoma

CLC Number:

R446.1

DING Xueqing, LIU Yu, TENG Jisen, CAO Wenjun, KONG Xiangmei, WANG Zhujian. Role of aqueous humor matrix metalloproteinase-3 in the differential diagnosis of glaucoma subtypes[J]. Laboratory Medicine, 2026, 41(7): 621-624.

Figures/Tables 3

References 20

[1]	Vision Loss Expert Group of the Global Burden of Disease Study, GBD 2019 Blindness and Vision Impairment Collaborators. Global estimates on the number of people blind or visually impaired by glaucoma:a meta-analysis from 2000 to 2020[J]. Eye (Lond), 2024,38(11):2036-2046.
[2]	Jayaram H, Kolko M, Friedman D S, et al. Glaucoma:now and beyond[J]. Lancet, 2023, 402(10414):1788-1801. DOI URL
[3]	Stein J D, Khawaja A P, Weizer J S. Glaucoma in adults-screening,diagnosis,and management:a review[J]. JAMA, 2021, 325(2):164-174. DOI URL
[4]	Kanski J J. Clinical ophthalmology:a synopsis[M]. London:Butterworth-Heinemann, 2009.
[5]	Baudouin C, Kolko M, Melik-parsadaniantz S, et al. Inflammation in glaucoma:from the back to the front of the eye,and beyond[J]. Prog Retin Eye Res, 2021, 83:100916. DOI URL
[6]	De Almeida L G N, Thode H, Eslambolchi Y, et al. Matrix metalloproteinases:from molecular mechanisms to physiology,pathophysiology,and pharmacology[J]. Pharmacol Rev, 2022, 74(3):712-768. DOI PMID
[7]	Nga A D, Yap S L, Samsudin A, et al. Matrix metalloproteinases and tissue inhibitors of metalloproteinases in the aqueous humour of patients with primary angle closure glaucoma-a quantitative study[J]. BMC Ophthalmol, 2014, 14:33. DOI URL
[8]	Pumphrey S A, Zitek-morrison E, Pizzirani S, et al. Evaluation of matrix metalloproteinases and tissue inhibitors of metalloproteinases in aqueous humor of dogs with versus without naturally occurring primary angle-closure glaucoma[J]. Am J Vet Res, 2021, 83(3):245-255. DOI URL
[9]	Bauer D, Kasper M, Walscheid K, et al. Alteration of MCP-1 and MMP-9 in aqueous humor is associated with secondary glaucoma in fuchs uveitis syndrome[J]. Ocul Immunol Inflamm, 2020, 28(4):688-698. DOI PMID
[10]	Okonkwo O N, Zeppieri M, Tripathy K. Posner-Schlossman syndrome[M]. StatPearls: StatPearls Publishing, 2025.
[11]	中华医学会眼科学分会青光眼学组, 中国医师协会眼科医师分会青光眼学组. 中国青光眼指南(2020年)[J]. 中华眼科杂志, 2020, 56(8):573-586.
[12]	李凤鸣, 谢立信. 中华眼科学[M]. 3版. 北京: 人民卫生出版社, 2014.
[13]	Kelley M J, Rose A Y, Song K, et al. Synergism of TNF and IL-1 in the induction of matrix metalloproteinase-3 in trabecular meshwork[J]. Invest Ophthalmol Vis Sci, 2007, 48(6):2634-2643. DOI URL
[14]	Kim Y S, Kim S S, Cho J J, et al. Matrix metalloproteinase-3:a novel signaling proteinase from apoptotic neuronal cells that activates microglia[J]. J Neurosci, 2005, 25(14):3701-3711. DOI URL
[15]	Sheng Q, Sun Y, Zhai R, et al. Urine cytomegalovirus localization and uveitic cell infiltration might both contribute to trabecular meshwork impairment in Posner-Schlossman syndrome:evidence from an open-angle rat model[J]. Exp Eye Res, 2023, 231:109477. DOI URL
[16]	Choi J A, Kim J E, Noh S J, et al. Enhanced cytomegalovirus infection in human trabecular meshwork cells and its implication in glaucoma pathogenesis[J]. Sci Rep, 2017, 7:43349. DOI PMID
[17]	Li J, Ji Y, Yang W, et al. Analysis of risk factors associated with secondary open-angle glaucoma in Posner-Schlossman syndrome:a retrospective case-control study[J]. Front Med(Lausanne), 2023, 9:1064449.
[18]	Yu L, Zhang L, He L, et al. The incidence and risk factors of optic nerve damage of Posner-Schlossman syndrome:a meta-analysis[J]. Altern Ther Health Med, 2023, 29(8):384-388.
[19]	Jap A, Sivakumar M, Chee S P. Is Posner Schlossman syndrome benign?[J]. Ophthalmology, 2001, 108(5):913-918. DOI PMID
[20]	Ashworth Briggs E L, Toh T, Eri R, et al. TIMP1,TIMP2,and TIMP4 are increased in aqueous humor from primary open angle glaucoma patients[J]. Mol Vis, 2015, 21:1162-1172. PMID

组别	例数	MMP-3/（ng·mL^-1）
PSS组	37	19.2（10.2，31.3）^*#
POAG组	32	3.2（0.0，11.4）
ACG组	31	17.7（6.2，45.4）^*#
对照组	25	4.7（0.8，7.1）
H值		36.797 8
P值		<0.000 1

组别	例数	MMP-3/（ng·mL^-1）
PSS组	37	19.2（10.2，31.3）^*#
POAG组	32	3.2（0.0，11.4）
ACG组	31	17.7（6.2，45.4）^*#
对照组	25	4.7（0.8，7.1）
H值		36.797 8
P值		<0.000 1