Abstract
Aim. To assess systemic levels of CD95 (Fas) and ICAM-1 (CD54) in patients with secondary neovascular glaucoma (NVG), to determine the relationship with the severity of iris rubeosis and the iridocorneal angle, and to evaluate the role of endothelial apoptosis in neovascular remodelling of the anterior segment of the eye.
Materials and methods. A single-centre cross-sectional study included 186 eyes with secondary NVG (96 associated with proliferative diabetic retinopathy and 90 following retinal vein occlusion) and 34 eyes in the control group. The severity of rubeosis was assessed using the Weiss grading scale. CD95 and ICAM-1 levels in peripheral blood were measured using an immunocytochemical method.
Results. In patients with NVG, CD95 and ICAM-1 levels were significantly higher compared with controls (p < 0.001). Both markers positively correlated with the severity of rubeosis according to Weiss (CD95: rs = 0.46; ICAM-1: rs = 0.45; p < 0.001) and with intraocular pressure. In a multivariable ordinal logistic regression model, CD95 and ICAM-1 remained independently associated with more severe rubeosis after adjustment for aetiology and intraocular pressure (CD95: OR = 2.31; 95% CI 1.27-4.18; p = 0.006; ICAM-1: OR = 2.48; 95% CI 1.56-3.95; p < 0.001). ROC analysis demonstrated moderate discriminative ability of the markers for detecting clinically significant rubeosis (Weiss ≥ II): AUC = 0.729 for CD95 and AUC = 0.730 for ICAM-1. Cut-off values were 687 cells/µL and 542 cells/µL, respectively.
Conclusions. CD95 (Fas) and ICAM-1 (CD54) are associated with the severity of rubeosis in secondary NVG and may serve as systemic biomarkers for neovascular remodelling and risk stratification of disease progression.