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Decreased Serum Levels of Complement C3 Reflect Complement System Dysregulation in Patients With Primary Open-angle Glaucoma

Results From a Pilot Study

Li, Shengjie MD*,†; Li, Danhui MD; Shao, Mingxi MD*; Cao, Wenjun MD*,†; Sun, Xinghuai MD†,§,∥,¶

doi: 10.1097/IJG.0000000000001014
Original Studies

Purpose: To evaluate the serum complement component (C)3 concentration in patients with primary open-angle glaucoma (POAG) and to investigate the association between C3 levels and POAG severity.

Materials and Methods: This study enrolled 190 consecutive POAG patients and 204 normal control subjects. A detailed eye and systematic examination, including intraocular pressure, gonioscopy, fundus photography, A-scan ultrasound, visual field testing, electrocardiograms, x-rays, liver function, renal function, infectious disease, etc., and measurement of serum C3 concentration by immunoturbidimetry, was performed. The subgroups were classified according to age (17 to 29, 30 to 49, 50 to 69, 70+ y), sex, and visual field: mild (MD≤6 dB), moderate (6 dB<MD≤12 dB), and severe (MD>12 dB) glaucoma.

Results: The serum C3 level of the POAG (95.63±17.71 mg/dL) was ∼20.93% lower than that of the control group (115.65±22.19 mg/dL) (P<0.001). A similar result was observed when serum levels of C3 were compared between the POAG and control groups with respect to age and sex. The mean serum C3 level was lowest in the severe POAG group (85.18±19.62 mg/dL), followed by the moderate POAG group (96.62±12.63 mg/dL) and the mild POAG group (110.44±14.89 mg/dL) (P<0.001). Multiple logistic regression analyses revealed a significant correlation between the C3 levels and the vertical cup-disc ratio (B=−0.373, P=0.026), C3 levels and MD (B=−0.546, P=0.001). Logistic regression analyses revealed that serum C3 levels were associated (odds ratio=0.939, 95% CI=0.901-0.979, P=0.003) with severity of POAG.

Conclusions: The POAG patients had decreased C3 levels, which were further negatively associated with POAG severity, suggesting the involvement of C3 in the pathomechanisms of POAG.

Departments of *Clinical Laboratory

Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University

§State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University

Key Laboratory of Myopia, Ministry of Health, Fudan University

Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai

Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Medical School, Xi’an Jiaotong University, Xi’an, Shanxi, China

Supported by Shanghai Sailing Program (18YF1403500), Shanghai Municipal Commission of Health and Family Planning (20174Y0169).

Disclosure: The authors declare no conflict of interest.

Reprints: Wenjun Cao, MD, No. 83 Fenyang Road, Shanghai 200031, China (e-mail:

Received February 10, 2018

Accepted June 16, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.