In a preprint study, researchers from Australia suggest retinal age gap as a tool to screen persons at high risk of future cardiovascular events.¹

In this study, a total of 33,817 participants without any history of CVD events at baseline were examined to investigate the association of retinal age gap with new onset of cardiovascular disease (CVD). Arterial stiffness index (ASI) was selected as a marker of subclinical CVD due to its noninvasive nature, which was measured by digital volume pulse. Hospital admission records were examined to identify CVD events (date of the first known myocardial infarction or stroke). A deep learning (DL) model was developed using 19,200 fundus images from the right eyes of 11,052 participants who had no previous disease. Retinal age gap was determined for the remaining 35,917 participants. It was defined as the retinal age predicted minus chronological age. “The retinal age gap would be positive for an ‘older’ appearing retina compared to chronological age, while a ‘younger’ appearing retina would have a negative retinal age gap.”

The study participants were a part of the UK Biobank study, a large-scale prospective study with more than half a million patients aged 40–69 years recruited between 2006 and 2010.

Incident cardiovascular events occurred in 675 participants after a median follow up of 5.83 years. Analysis of data further showed a significant increase in ASI with a 1-year increase in the retinal age gap. Each 1-year increase in retinal age gap was associated with a 3% increase in the risk of incident CVD with a hazard ratio (HR) of 1.03. A marked increase in the risk of incident CVD was noted with retinal age gap of 1.21 (HR 1.05).

Arterial stiffness is an early indicator of atherosclerosis and an established predictor of cardiovascular events and related mortality. Correlation between arterial stiffness and retinal microvasculature has been documented in previous studies with higher ASI indicative of microcirculation dysfunction. The present study has shown a significant association of retinal age gap with ASI and incident CVD events. The study authors therefore suggest that the retinal age gap may be used as a new potential noninvasive marker of subclinical CVD and to identify persons at high risk of future cardiac events.

Reference

1. Zhuoting Zhu, et al. Association of retinal age gap with arterial stiffness and incident cardiovascular disease. medRxiv, posted January 14, 2022. doi: https://doi.org/10.1101/2022.01.13.22269272.