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  • Serum complement component 3, complement component 4 and complement component 1q levels predict progressive visual field loss in older women with primary angle closure glaucoma

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Clinical science
Serum complement component 3, complement component 4 and complement component 1q levels predict progressive visual field loss in older women with primary angle closure glaucoma
  1. Shengjie Li1,
  2. Yichao Qiu1,
  3. Jian Yu2,
  4. Mingxi Shao1,
  5. Yingzhu Li1,
  6. Wenjun Cao1,
  7. Xinghuai Sun2,3,4,5
  1. 1 Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  2. 2 Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  3. 3 State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
  4. 4 Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
  5. 5 NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
  1. Correspondence to Dr Wenjun Cao, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; wgkjyk{at}aliyun.com

Abstract

Aim To evaluate the association between serum levels of complement component (C) 3, C4 and C1q and visual field (VF) loss in patients with primary angle closure glaucoma (PACG).

Methods In this prospective cohort study, a total of 308 patients with PACG were included. The patients were followed up every 6 months (at least 2 years), with clinical examination and VF testing. Based on their sex and age, the subjects were stratified into male and female subgroups, and by age at <60 and ≥60 years per subgroup.

Results One hundred twenty-three (39.94%) patients showed glaucoma VF progression. The serum levels of C3, C4 and C1q were significantly lower (p<0.05) in the progression group compared with the non-progression group in the ≥60 years female subgroup. In female patients with age ≥60 years, (1) lower levels of baseline C3 (HR=0.98, p<0.001), C4 (HR=0.96, p=0.01) and C1q levels (HR=0.99, p=0.003) were associated with a greater risk of VF progression; (2) patients with lower C3 levels had significantly (p<0.05) higher rates of VF loss progression, similar to those with lower C4 and lower C1q levels; and (3) the generalised additive model revealed a negative correlation between baseline C3 (p<0.001), C4 (p<0.001) and C1q (p<0.001) levels with the risk of VF progression. No statistical significance was observed in the male (<60 and ≥60 years) and female (<60 years) subgroups.

Conclusion Decreased C3, C4 and C1q levels at baseline were significantly associated with a greater risk of VF loss progression only in older women with PACG.

  • glaucoma
  • immunology
  • inflammation

Data availability statement

Data are available upon reasonable request. Not applicable.

https://doi.org/10.1136/bjophthalmol-2021-320541

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    Data availability statement

    Data are available upon reasonable request. Not applicable.

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    Footnotes

    • Contributors SL, YQ, JY, MS, YL, WC and XS—data analysis and interpretation, manuscript preparation and revision. SL and WC—research design and execution, data acquisition and revision. All authors approved the final version of the manuscript. WC is the guarantor for this study.

    • Funding This work was supported by the Excellent Physician - Excellent Clinical Researcher Plan (SYA202004), The State Key Programme of National Natural Science Foundation of China (81430007), The subject of major projects of National Natural Science Foundation of China (81790641), The Shanghai Committee of Science and Technology, China (17410712500) and the top priority of clinical medicine center of Shanghai (2017ZZ01020). Shanghai Science and Technology Committee Foundation grant (19411964600).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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