Association between aqueous humor MMP-3 levels and varicella zoster virus-induced acute retinal necrosis

Abstract Objective This study aims to investigate the correlation between matrix metalloproteinase-3 (MMP-3) levels in the aqueous humor and the development of varicella-zoster virus-induced acute retinal necrosis (ARN). Methods Twenty eyes in 20 patients diagnosed with ARN were enrolled, with all the medical records retrospectively reviewed. Aqueous humor samples were collected before the initial antiviral treatments, and MMP-3 levels were quan­tified using immunoturbidimetry. Controls consisted of fifteen eyes from age-related cataract (ARC) patients. Correla­tions between aqueous humor MMP-3 levels and ophthalmic examination results were analyzed using Spearman's cor­relation test. Results MMP-3 were significantly higher in the aqueous humor of ARN patients compared to the controls. (P<0.001). The following correlations for aqueous humor MMP-3 levels were observed: A low negative correlation with BCVA was observed (r=-0.447, P=0.0483). A moderate positive correlation was found with the percentage of active retinal necrosis area (r=0.773, P=0.0001). A moderate negative correlation was identified with vitreous haze (r= -0.642, P= 0.0023). No significant correlation was found between MMP-3 levels and intraocular pressure or disease duration (P>0.05). The risk of retinal detachment (RD) was predicted by high MMP-3 levels (HR=4.473; 95% CI, 1.143-17.50; P=0.0314). Conclusion It is suggested by our findings that MMP-3 may play a crucial role in the pathogenesis of ARN, and the detection of aqueous humor MMP-3 is deemed to hold clinical value for both the treatment and prognosis of ARN.