Aqueous Humor Neurofilament Light Chain is a Marker of Neurodegeneration in Glaucoma

Abstract

Purpose : Neurofilament light chain (NfL) is a neuronal cytoskeletal protein that has been identified as a marker of neurodegeneration. Here, we investigated whether NfL in the aqueous humor (AH) can serve as a marker of glaucomatous neurodegeneration in a racially diverse North American population.

Methods : In this single-center, case-control study, we collected AH from 39 glaucoma patients and 10 patients without glaucoma undergoing ophthalmic surgery. AH NfL was quantified using the highly sensitive Single-Molecule Array (Simoa)® NF-light assay (Quanterix). Clinical information was obtained by reviewing the medical record.

Results : In a generalized linear model controlling for age and body mass index (BMI), AH NfL was significantly elevated in glaucoma patients (mean: 429 pg/ml; standard deviation [SD]: 1136 pg/ml) compared to patients without glaucoma (mean: 3.1 pg/ml; SD: 1.9 pg/mg): P=0.002. Higher AH NfL was associated with higher maximum intraocular pressure (IOP) (R=0.44, P=0.005), higher pre-operative IOP (R=0.46, P=0.003), and more pre-operative glaucoma medications (Rs=0.61, P<0.001).

Conclusions : We provide evidence that AH NfL may have clinical utility as a marker of glaucomatous neurodegeneration. While further validation is necessary, our findings provide a foundation for longitudinal studies investigating the potential role of NfL in clinical practice.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.