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Clinical science
Neurofilament light chain: a new marker for neuronal decay in the anterior chamber fluid of patients with glaucoma
  1. Nora Woltsche1,
  2. Katharina Valentin1,
  3. Lukas Hoeflechner1,
  4. Andreas Guttmann1,
  5. Jutta Horwath-Winter2,
  6. Mona Regina Schneider2,
  7. Domagoj Ivastinovic2,
  8. Marlene Lindner3,
  9. Leopold Schmetterer4,5,
  10. Neena Singh6,
  11. Regina Riedl7,
  12. Arabella Buchmann8,
  13. Michael Khalil8,
  14. Ewald Lindner1
  1. 1 Department of Ophthalmology, Medical University of Graz, Graz, Austria
  2. 2 Department of Ophthalmology, Medical University Graz, Graz, Austria
  3. 3 Department of Dentistry, Medical University of Graz, Graz, Steiermark, Austria
  4. 4 Ocular Imaging, Singapore Eye Research Institute, Singapore
  5. 5 Department of Clinical Pharmacology, Medical University of Vienna, Wien, Austria
  6. 6 Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
  7. 7 Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria
  8. 8 Department of Neurology, Medical University of Graz, Graz, Steiermark, Austria
  1. Correspondence to Dr Ewald Lindner, Medical University of Graz, Graz, Austria; ewald.lindner{at}medunigraz.at

Abstract

Background/Aims Neurofilament light chain (NfL) levels in cerebrospinal fluid and serum are reliable indicators for neuroaxonal damage in a broad spectrum of neurodegenerative diseases. Herein, we investigate NfL levels in serum and anterior chamber fluid of patients with glaucoma.

Methods Patients scheduled for routine glaucoma or cataract surgery were recruited for this study. Retinal nerve fibre layer thickness was measured by optical coherence tomography (OCT, Heidelberg Spectralis). NfL levels in serum and in anterior chamber fluid were analysed with Simoa SR-X Analyzer (Quanterix; NFLIGHT, Lexington, Massachusetts, USA). T-test was used for parametric data and Mann-Whitney-U test for nonparametric data. Spearman’s rank-order correlation was used to investigate correlations. P values<0.05 were considered as statistically significant.

Results Sixty patients with glaucoma and 58 controls were enrolled. Serum NfL concentration of patients with glaucoma was similar to serum NfL concentration in controls (median (IQR); 22.7 (18.9) pg/mL vs 22.5 (24.0) pg/mL; p=0.763). A positive correlation of serum NfL with age was observed in both patients with glaucoma (r=0.77; p<0.001) and in the control group (r=0.82, p<0.001). In the anterior chamber fluid, the NfL concentration was substantially increased in patients with glaucoma compared with controls (20.7 (101.3) pg/mL vs 3.1 (2.9) pg/mL; p<0.001). Furthermore, we found a positive correlation of anterior chamber fluid NfL with preoperative intraocular pressure (r=0.39, p=0.003) and with retinal nerve fibre layer thickness (r=0.58, p<0.001).

Conclusion NfL levels in anterior chamber fluid are elevated in patients with glaucoma and correlate with intraocular pressure and retinal nerve fibre layer thickness. The presented data strongly support anterior chamber fluid NfL as a new marker for glaucoma.

  • Glaucoma
  • Anterior chamber
  • Aqueous humour

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/bjo-2021-320828

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • MK and EL are joint senior authors.

    • Contributors NW, MK and EL made a substantial contribution to the present work in the design of the study, acquisition, analysis and interpretation of data, manuscript drafting and approval of the version of the manuscript to be published. MK and EL share senior authorship. KV, LH, AG, JH-W, MRS and ML had contributed to acquisition of data, critical revision for important intellectual content and approval of the version to be published. DI, NS, LS had an important participation in the critical revision for important intellectual content and approval of the present version of the manuscript. AB provided acquisition of data, critical revision for important intellectual content and approval of the present version of the manuscript. RR provided analysis and interpretation of data, manuscript drafting and approval of the version of the manuscript to be published. EL is responsible for the overall content as the guarantor.

    • Funding This study was funded by means of the Medical University of Graz.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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