The Diagnostic and Prognostic Value of Neurofilament Heavy Chain Levels in Immune-Mediated Optic Neuropathies

Abstract

Background . Loss of visual function differs between immune-mediated optic neuropathies and is related to axonal loss in the optic nerve. This study investigated the diagnostic and prognostic value of a biomarker for neurodegeneration, the neurofilament heavy chain (NfH) in three immune-mediated optic neuropathies. Methods . A prospective, longitudinal study including patients with optic neuritis due to multiple sclerosis (MSON, n=20 ), chronic relapsing inflammatory optic neuritis (CRION, n=19 ), neuromyelitis optica (NMO, n=9 ), and healthy controls ( n=28 ). Serum NfH-SMI35 levels were quantified by ELISA. Findings . Serum NfH-SMI35 levels were highest in patients with NMO (mean 0.79±1.51 ng/mL) compared to patients with CRION ( 0.13±0.16 ng/mL, P=0.007 ), MSON ( 0.09±0.09 , P=0.008 ), and healthy controls ( 0.01±0.02 ng/mL, P=0.001 ). High serum NfH-SMI35 levels were related to poor visual outcome. Conclusions . Blood NfH-SMI35 levels are of moderate diagnostic and more important prognostic value in immune-mediated optic neuropathies. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions.