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Monitoring retinal cell layer thickness provides a non-invasive window into the central nervous system. Because the retina is an anatomical extension of the brain, structural changes there often reflect systemic neurodegenerative processes. Specifically, researchers are currently studying glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) for their associations with retinal thinning. A recent cross-sectional study evaluated these relationships in ophthalmic surgical patients using optical coherence tomography.
The research demonstrated that higher plasma GFAP levels significantly correlate with thinner inner retinal layers. Specifically, patients showed a thinner retinal nerve fiber layer at the superior, nasal, and inferior outer macula. Furthermore, elevated GFAP levels correlated with a thinner ganglion cell layer across several inner and outer macular regions. However, plasma NfL levels showed a limited association, specifically with ganglion cell thickness only in the superior inner macula. Consequently, plasma GFAP appears to be a stronger indicator of systemic astroglial activation in these patients.
These findings suggest that systemic inflammation and astroglial activation may drive structural changes in the eye. Therefore, assessment of retinal cell layer thickness could potentially serve as a biomarker for neurodegenerative risk. Practitioners should integrate these insights when reviewing ocular scans for patients with potential cognitive decline. Moreover, these structural changes provide clear evidence of the ocular-brain axis. Future longitudinal studies will likely refine how these biomarkers can guide early intervention strategies in clinical settings.
The retina shares embryological origins with the brain. Therefore, thinning in layers like the ganglion cell layer can reflect early neuroaxonal damage or astroglial activation seen in Alzheimer's disease.
GFAP serves as a marker for astroglial activation, while NfL represents neuroaxonal injury. This study found that GFAP has a broader association with retinal thinning than NfL, making it a potentially more sensitive indicator.
Disclaimer: This content is for informational and educational purposes only... Refer to the latest local and national guidelines for clinical practice.
References
Prasad M et al. Association of plasma glial fibrillary acidic protein and neurofilament light chain with retinal cell layer thickness: A cross-sectional study of ophthalmic surgical patients. J Alzheimers Dis. 2026 May 30. doi: 10.1177/13872877261452676. PMID: 42216665.
Hansson O, et al. Blood-based biomarkers for Alzheimer’s disease. Nature Medicine. 2022;28(12):2477-2488.
Ashton NJ, et al. Plasma GFAP as a biomarker for Alzheimer's disease: A systematic review and meta-analysis. JAMA Neurology. 2021;78(11):1-10.
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