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Background <p>To investigate whether alterations in iris extracellular matrix (ECM) composition represent a characteristic stromal feature contributing to primary angle closure disease (PACD).</p> Methods <p>Hospital-based, cross-sectional study. Patients with PACD, primary open angle glaucoma (POAG), or secondary glaucoma who underwent trabeculectomy or peripheral iridectomy at Beijing Tongren Hospital between October 2024 and July 2025 were included. Stromal area fractions of iris type I collagen, type III collagen, and secreted protein acidic and rich in cysteine (SPARC) were quantified and compared among disease groups, across PACD subtypes, and between visual field severity stages in PACG and POAG. Associations with anterior-segment biometric parameters were also evaluated.</p> Results <p>A total of 117 patients (122 eyes: 56 PACD, 31 POAG, 35 secondary glaucoma) were analyzed. Type I collagen expression was significantly higher in PACD than in POAG and secondary glaucoma (<i>P</i> &lt; 0.001). SPARC showed an overall group difference (<i>P</i> = 0.026), whereas type III collagen did not (<i>P</i> = 0.914). Within PACD, ECM markers did not differ among subtypes and showed no correlations with anterior-segment biometry (all <i>P</i> &gt; 0.05). ECM expression also did not vary by disease severity in PACG or POAG.</p> Conclusions <p>PACD demonstrated selective elevation of iris type I collagen, with a numerical trend toward higher SPARC expression, independent of disease subtype, severity or anterior-segment anatomy. These findings support iris ECM remodeling may represent a characteristic structural feature contributing to angle closure susceptibility.</p>

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Iris extracellular matrix remodeling in primary angle closure disease: increased type I collagen and SPARC in human iris tissue

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Hui Zhang,
  • Zijian Liu,
  • Jin Wang,
  • Yue Wang,
  • Jiaying Li,
  • Shuhua Wang,
  • Ningli Wang,
  • Ye Zhang

摘要

Background

To investigate whether alterations in iris extracellular matrix (ECM) composition represent a characteristic stromal feature contributing to primary angle closure disease (PACD).

Methods

Hospital-based, cross-sectional study. Patients with PACD, primary open angle glaucoma (POAG), or secondary glaucoma who underwent trabeculectomy or peripheral iridectomy at Beijing Tongren Hospital between October 2024 and July 2025 were included. Stromal area fractions of iris type I collagen, type III collagen, and secreted protein acidic and rich in cysteine (SPARC) were quantified and compared among disease groups, across PACD subtypes, and between visual field severity stages in PACG and POAG. Associations with anterior-segment biometric parameters were also evaluated.

Results

A total of 117 patients (122 eyes: 56 PACD, 31 POAG, 35 secondary glaucoma) were analyzed. Type I collagen expression was significantly higher in PACD than in POAG and secondary glaucoma (P < 0.001). SPARC showed an overall group difference (P = 0.026), whereas type III collagen did not (P = 0.914). Within PACD, ECM markers did not differ among subtypes and showed no correlations with anterior-segment biometry (all P > 0.05). ECM expression also did not vary by disease severity in PACG or POAG.

Conclusions

PACD demonstrated selective elevation of iris type I collagen, with a numerical trend toward higher SPARC expression, independent of disease subtype, severity or anterior-segment anatomy. These findings support iris ECM remodeling may represent a characteristic structural feature contributing to angle closure susceptibility.