ANGPTL7 is a secreted extracellular matrix-associated protein with pleiotropic functions across ocular, hematopoietic, and metabolic systems. In the eye, ANGPTL7 mediates dexamethasone-induced matrix deposition in the trabecular meshwork and serves as a negative regulator of corneal angiogenesis, maintaining corneal avascularity 1. However, ANGPTL7 plays a paradoxical pro-angiogenic role in pathological contexts: in knee osteoarthritis, Angptl7+ chondrocytes promote subchondral bone angiogenesis via FGF2-FGFR2 signaling, facilitating osteogenic remodeling and disease progression 2. Similarly, elevated ANGPTL7 promotes endothelial cell proliferation and choroidal neovascularization in wet age-related macular degeneration 3 and correlates with intraocular pressure dysregulation in high myopia 4. Beyond angiogenesis, ANGPTL7 regulates hematopoietic stem/progenitor cell expansion through Wnt signaling activation 5 and supports leukemia stem cell maintenance in the bone marrow microenvironment 6. Metabolically, ANGPTL7 promotes insulin resistance and type 2 diabetes via SOCS3-mediated IRS1 degradation 7. Clinically, loss-of-function ANGPTL7 variants protect against glaucoma and reduce intraocular pressure, while ANGPTL7-neutralizing antibodies lower IOP in both naïve and steroid-induced hypertensive eyes 18, positioning ANGPTL7 as a promising therapeutic target for glaucoma management.