Tumor Necrosis Factor-alpha Concentrations in the Aqueous Humor of Patients with Glaucoma

Purpose: To investigate the concentration of tumor necrosis factor (TNF)-alpha in the aqueous humor of patients with glaucoma, including correlations with glaucoma subtypes and intraocular pressure.

Methods: The study population comprised 84 patients with open-angle glaucoma who were scheduled for filtration or cataract surgery. Glaucoma subgroups included 29 cases of primary open-angle glaucoma (POAG), 28 cases of normal-tension glaucoma (NTG), and 27 cases of exfoliation glaucoma (ExG). Seventy-nine patients with senile cataract were recruited as control subjects. The concentrations of TNF-alpha in the aqueous humor were measured with an enzyme-linked immunosorbent assay. The percentages of samples positive for TNF-alpha and the measured concentrations in the glaucoma and cataract groups were compared. In addition, the relationships with the glaucoma subtypes, intraocular pressure, and glaucoma severity were analyzed.

Results: A significantly higher percentage of subjects in the glaucoma group were positive for TNF-alpha compared with the cataract group (P = 0.011). The mean TNF-alpha concentrations among the positive cases were not different between the groups (P = 0.689). TNF-alpha-positive samples were higher in the POAG (13.7%) and NTG (10.7%) subgroups than in the cataract group without significance, but higher in ExG subgroup (29.6%) with significance (P = 0.001). Relationships between the TNF-alpha concentration and the intraocular pressure or the clinical stage of glaucoma were not observed.

Conclusions: TNF-alpha levels were significantly higher in the glaucoma group than in the cataract group, with a particularly large difference observed in those with ExG. The results suggest that TNF-alpha plays a key role in the progression of glaucoma.