title: Aqueous Humor Levels of TGF-β2 and TNF-α in Indonesian Eyes With Acute Primary Angle Closure.
abstract: OBJECTIVE
  To measure aqueous humor levels of TGF-β2 and TNF-α in Indonesian eyes with acute primary angle closure (APAC) and to investigate their relationship to response to treatment.
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  On presentation, aqueous humor samples were taken from APAC eyes by paracentesis. All APAC eyes then underwent laser peripheral iridotomy (LPI). Two weeks following LPI, trabeculectomy was performed if the intraocular pressure (IOP) was still high. Alternatively, phacoemulsification was performed in cases of normal IOP. Aqueous humor samples were taken again at the time of both surgical procedures. Age-matched cataract patients were included as a control group. Cytokine samples were measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Forty-three Indonesian APAC subjects were recruited in this study. The mean presenting IOP was 56.4 ± 0.52 mmHg and 53% underwent trabeculectomy. Comparison of the APAC eyes to the control group showed there was a significant difference in the mean levels of TGF-β2 (2007.7 ± 827.2 pg/mL vs 466.1 ± 219.3 pg/mL, p < 0.001) and TNF-α (0.714 ± 0.33 pg/mL vs 0.228 ± 0.16 pg/mL, p < 0.001). There was no significant difference in the presented TGF-β2 and TNF-α levels between the trabeculectomy and phacoemulsification groups (p:0.391 and p:0.494). Between presentation and surgery in the trabeculectomy subgroup, both cytokine levels appeared to be significantly different (p < 0.035 and p < 0.038).
  
  
  CONCLUSIONS
  This study showed the aqueous humor levels of TGF-β2 and TNF-α appeared high at presentation but decreased subsequently, with no difference detected between groups with persistently high IOP and those with normalized IOP.
authors.affiliation: From the *Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia; †Department of Ophthalmology, Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; ‡Singapore Eye Research Institute and Singapore National Eye Center; and §Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Widya
authors.initials: W
authors.lastname: Artini
authors.forename: Tjahjono Darminto
authors.initials: TD
authors.lastname: Gondhowiardjo
authors.forename: Edi S
authors.initials: ES
authors.lastname: Supiandi
authors.forename: Aung
authors.initials: A
authors.lastname: Tin