The serum proteins neurofilament light chain and glial fibrillary acidic protein (GFAP) and brain-derived neurotrophic factor (BDNF) appear to predict disease severity and prognosis in patients with optic neuritis due to neuromyelitis optica spectrum disorder (NMOSD) or other causes, according to a recently published study in Scientific Reports.

Due to the severe consequences and permanent sequelae associated with optic neuritis, easily measurable biomarkers are required to guide the clinical management of the disease. Although the newly developed ultrasensitive single-molecule array analysis has been proven capable of detecting clinically relevant biomarkers in several neurological conditions, there are doubts regarding their clinical validity in the context of optic neuritis, mainly due to the fact that the optic nerve represents a very small fraction of the central nervous system.

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The authors aimed to analyze the prognostic value of the serum proteins GFAP and BDNF through a prospective study including 60 patients with a history of central nervous system demyelinating diseases who experienced optic neuritis as their last attack. Protein levels were compared at remission and attack to assess their prognostic potential.

Of the included population, 15 patients had NMOSD and 14 had myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorder; the rest were classified as double-seronegative optic neuritis.

Results revealed that patients with NMOSD had significantly higher GFAP levels than the rest of the studied population. Furthermore, in the NMOSD group, GFAP levels were significantly higher during attacks than during remissions and were correlated with a greater loss of visual acuity.

Serum BDFN levels, on the other hand, were associated with improved visual function during follow-up in patients with NMOSD. However, in the other groups, BDNF levels had no significant prognostic value.

“In this prospective longitudinal cohort study, serum GFAP levels reflected disease status and severity in [optic neuritis with anti-aquaporin-4 antibodies], while serum BDNF showed potential as a prognostic marker for patients with [optic neuritis with anti-aquaporin-4 antibodies],” the authors concluded.


Kim HJ, Lee EJ, Kim SY, et al. Serum proteins for monitoring and predicting visual function in patients with recent optic neuritis. Sci Rep. Published online April 5, 2023. doi:10.1038/s41598-023-32748-5