Aqueous Humor Cytokine Profiles in Congenital Cataracts With Posterior Polar Abnormality and Associations With...

To characterize the aqueous humor (AH) cytokine profiles across clinical subtypes of congenital cataracts with posterior polar abnormality (PPA) and to assess their associations with postoperative complications.

This prospective study included 96 eyes with congenital cataracts divided into a PPA group (n = 78) and non-PPA controls (n = 18). The PPA group was stratified into four clinical subtypes: congenital cataract with persistent fetal vasculature (PFV, n = 27), posterior polar cataract (PPC; n = 16), posterior lenticonus (PL; n = 17), and posterior capsule defect (PCD; n = 18). Baseline demographics and biometrics were collected. Thirteen cytokines in AH were measured using Luminex xMAP technology. Postoperative complications, including visual axis opacification (VAO) and glaucoma-related adverse events, were evaluated with a minimum follow-up of 12 months.

The PPA group showed differences in several cytokines compared with non-PPA controls, including higher vascular endothelial growth factor A (VEGF-A), fibroblast growth factor 2 (FGF2), and neurotrophin-4 (NT-4) and lower fibroblast growth factor 1 (FGF1) and platelet-derived growth factor-AA (PDGF-AA) (all q < 0.05, false discovery rate adjusted). Cytokine patterns varied across PPA subtypes, with substantial overlap. PFV showed higher levels of several markers, whereas PPC and PL showed lower levels. In exploratory Firth logistic regression, higher NT-4 (odds ratio [OR] = 1.16; 95% confidence interval [CI], 1.02-1.36; P = 0.028) and PDGF-AA (OR = 1.06; 95% CI, 1.01-1.12; P = 0.027) were associated with postoperative VAO.

PPA showed AH cytokine differences compared with non-PPA controls. Across PPA subtypes, cytokine distributions showed substantial overlap despite exploratory differences in several markers. Higher NT-4 and PDGF-AA were associated with postoperative VAO in exploratory analyses and warrant further validation.