GROWTH-FACTORS IN THE AQUEOUS-HUMOR AND THEIR THERAPEUTIC IMPLICATIONS IN GLAUCOMA AND ANTERIOR SEGMENT DISORDERS OF THE HUMAN EYE

The presence of growth-promoting substances in the aqueous humor has been suspected for the past decade, but it has been only during the last 2 years that the existence of growth factors such as basic fibroblast growth factor, epidermal growth factor, transforming growth factor-beta, transferrin, and insulin-like growth factors in the aqueous humor has been demonstrated. The structures that border the anterior and posterior chambers of the eye synthesize some of these growth factors and release them into the aqueous humor. A breakdown of the blood-aqueous-barrier increases the amounts of growth factors and may also bring platelet-derived growth factor, nerve growth factor, and interleukin-6 into the aqueous humor. Growth factors maintain the normal function of ocular tissues in health and have a significant role in the pathogenesis and possible management of several disorders of the eye. The outcome of the pathogenetic process and its modulation are determined by a complex coordination and interactions of the growth factors in the aqueous humor and their eventual effect on the target tissues. We discuss the therapeutic implications of growth factors and their antagonists in the treatment of certain disorders of the anterior segment of the eye, including rubeosis iridis, neovascular glaucoma, primary open-angle glaucoma, and wound healing after glaucoma filtration surgery.