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Invest Ophthalmol Vis SciOctober 20250 citations

Elevated Neurodegeneration Markers in the Aqueous Humor of Primary Open Angle and Normal Tension Glaucoma Patients Correlate With Disease Severity.

Nair Archana Padmanabhan, Tejwani Sushma, Dinakaran Shoruba, Shetty Naren, Shetty Rohit, Ghosh Arkasubhra, Sethu Swaminathan


AI Summary

Aqueous humor neurodegeneration markers were elevated in glaucoma patients, correlating with disease severity. This suggests their potential as diagnostic biomarkers or therapeutic targets for glaucoma.

Abstract

Purpose

Glaucoma, a degenerative condition of the optic nerve, results in irreversible blindness. Intraocular monitoring of neurodegeneration markers will help in early diagnosis, prognostication, and unravelling novel disease mechanisms. Thus, we evaluated neurodegeneration markers in patients with glaucoma and correlated them with clinical parameters.

Methods

Aqueous humor (AH) from patients with primary open angle glaucoma (POAG; 26 eyes), normal tension glaucoma (NTG; 10 eyes), and non-glaucomatous controls (18 eyes) were collected at the time of trabeculectomy and/or cataract surgery. The levels of amyloid-beta (Aβ)40, Aβ42, β-synuclein, glial fibrillary acidic protein (GFAP), neurofilament heavy chain (NfH), neurofilament light chain (NfL), total Tau (t-Tau), and ubiquitin C-terminal hydrolase L1 (UCHL1) were measured in AH using microfluidic cartridge-based multiplex ELISA.

Results

The levels of Aβ40, Aβ42, β-synuclein, GFAP, NfH, NfL, and t-Tau in the AH were significantly (P < 0.0001) higher in patients with POAG compared with the healthy controls. Whereas, Aβ40, Aβ42, and NfH were significantly (P < 0.05) higher in patients with NTG compared with controls. Area under the curve (AUC) analysis demonstrated that, in patients with POAG, Aβ40, Aβ42, GFAP, and NfH exhibited AUC values of 0.949, 0.929, 0.944, and 0.955, respectively, with 80% to 100% sensitivity and specificity (P < 0.0001). In patients with NTG, only NfH showed a comparable AUC of 0.944 with similar diagnostic accuracy. GFAP, Aβ42, and t-Tau levels were observed to be inversely associated with visual field index and/or retinal nerve fiber layer thickness of patients with POAG and/or NTG.

Conclusions

Increased intraocular levels of neurodegeneration markers and their association with clinical parameters in patients with POAG and/or NTG indicate their potential as biomarkers or therapeutic targets in the management of glaucoma.


MeSH Terms

HumansAqueous HumorMaleFemaleLow Tension GlaucomaBiomarkersMiddle AgedAgedGlaucoma, Open-AngleEnzyme-Linked Immunosorbent AssayAmyloid beta-PeptidesGlial Fibrillary Acidic ProteinNeurofilament ProteinsROC CurveSeverity of Illness Indextau ProteinsIntraocular Pressure

Key Concepts5

The levels of amyloid-beta (Aβ)40, Aβ42, β-synuclein, glial fibrillary acidic protein (GFAP), neurofilament heavy chain (NfH), neurofilament light chain (NfL), and total Tau (t-Tau) in the aqueous humor were significantly (P < 0.0001) higher in patients with primary open angle glaucoma (POAG) compared with healthy controls.

MechanismCross-sectionalCross-sectional studyn=26 eyes with POAG, 18 non-glaucomatou…Ch2Ch12

The levels of amyloid-beta (Aβ)40, Aβ42, and neurofilament heavy chain (NfH) in the aqueous humor were significantly (P < 0.05) higher in patients with normal tension glaucoma (NTG) compared with healthy controls.

MechanismCross-sectionalCross-sectional studyn=10 eyes with NTG, 18 non-glaucomatous…Ch2Ch12

In patients with primary open angle glaucoma (POAG), amyloid-beta (Aβ)40, Aβ42, glial fibrillary acidic protein (GFAP), and neurofilament heavy chain (NfH) exhibited area under the curve (AUC) values of 0.949, 0.929, 0.944, and 0.955, respectively, with 80% to 100% sensitivity and specificity (P < 0.0001) for diagnosing POAG.

DiagnosisCross-sectionalCross-sectional studyn=26 eyes with POAGCh11Ch12

In patients with normal tension glaucoma (NTG), only neurofilament heavy chain (NfH) showed a comparable area under the curve (AUC) of 0.944 with similar diagnostic accuracy for diagnosing NTG.

DiagnosisCross-sectionalCross-sectional studyn=10 eyes with NTGCh11Ch12

Glial fibrillary acidic protein (GFAP), amyloid-beta (Aβ)42, and total Tau (t-Tau) levels were observed to be inversely associated with visual field index and/or retinal nerve fiber layer thickness of patients with primary open angle glaucoma (POAG) and/or normal tension glaucoma (NTG).

PrognosisCross-sectionalCross-sectional studyn=26 eyes with POAG, 10 eyes with NTGCh5Ch6Ch12

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