Comparative Analysis of Biomarkers for Treatments of Optic Neuritis: A Systematic Review of Diagnostic Accuracy

Background: Optic neuritis (ON) is an inflammation of the optic nerve, presenting with acute or sub-acute vision loss, pain in eye movements, and potentially altered colour vision. This systematic review aims to analyse the diagnostic accuracy of various biomarkers for optic neuritis. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed while conducting this systematic review. The literature search encompassed various databases such as PubMed, Science Direct and Cochrane library. Studies published from 2014-2024 were included in the analysis. The quality of the included studies was meticulously evaluated using the proper tools suited to the study design. The synthesis and analysis of data included a summary of study characteristics, aims and objectives, biomarkers, and main study results/conclusions. Results: Sample sizes range from 16 to 246 participants. Common biomarkers include serum levels of AQP4-IgG and MOG-IgG, MRI characteristics, Optical Coherence Tomography (OCT) and Neurofilament light chain (NfL), GFAP, and BDNF. MOG-associated ON tends to present with more bilateral involvement and is often linked to better visual outcomes than AQP4-associated ON. The studies consistently show significant differences in MRI lesions profiles between NMO and MS, aiding clinical differentiation. Furthermore, various studies report that serum biomarkers, particularly GFAP and BDNF, correlate with visual outcomes and disease severity, shedding light on potential new diagnostic tools. Conclusion: This systematic review underlines the critical role of specific biomarkers and imaging techniques in diagnosing, prognosticating, and managing optic neuritis.