AIM: To explore the application value of serum pigment epithelial derived factors(PEDF), fibroblast growth factor 19(FGF19)and β-endorphin(β-EP)in the diagnosis and severity assessment of primary glaucoma.

METHODS: A total of 102 patients with primary glaucoma in the hospital were enrolled as study group between February 2018 and February 2020, while other 102 healthy controls during the same period were enrolled as control group. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between the two groups. And their diagnostic value for primary glaucoma was analyzed. The study group was divided into severe and non-severe groups according to the diagnostic criteria for severe primary glaucoma. The levels of peripheral serum PEDF, FGF19 and β-EP were compared between severe group and non-severe group. And their evaluation value for disease severity was analyzed. The risk factors of disease severity were analyzed by multivariate Logistic regression analysis.

RESULTS: The level of serum PEDF in study group was significantly lower than that in control group, while levels of FGF19 and β-EP were significantly higher than those in control group(P<0.001). AUC values of PEDF, FGF19 and β-EP levels in the diagnosis of primary glaucoma were 0.695, 0.754 and 0.768, respectively. The level of serum PEDF in severe group was significantly lower than that in non-severe group(P<0.001), while levels of FGF19 and β-EP were significantly higher than those in non-severe group(P<0.001). AUCvalues of PEDF, FGF19 and β-EP levels in assessing the severity of primary glaucoma were 0.731, 0.709 and 0.685, respectively. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L were independent influencing factors of severe primary glaucoma(OR=2.280, 1.570, 1.413, all P<0.05).

CONCLUSION: FGF19 and β-EP are of auxiliary diagnostic value in primary glaucoma, while PEDF and FGF19 are of evaluation value in disease severity. PEDF lower than 9.66pg/mL, FGF19 higher than 143.75ng/L and β-EP higher than 106.27ng/L are independent influencing factors of severe primary glaucoma.