Scientists have identified vascular health indicators that may help predict stroke risk.
- Changes
in the eye can help predict other health concerns in the body, such as
diabetes and high blood pressure.
- A
new study has identified a set of 29 vascular health indicators on the
retina, making a “fingerprint” that can help predict a person’s stroke
risk.
- Researchers
believe this method provides a less invasive way of testing stroke risk
than traditional tests.
While some may say the
eyes are a window to the soul, for quite a while, doctors have known that the eyes can also offer a view into a person’s overall
health.
“The retinaTrusted Source is one of the few places in the
body where blood vessels can be directly observed non-invasively. Changes in
the retinal blood vessels can indicate systemic vascular conditions such
as hypertension, diabetes,
and atherosclerosis,” Mingguang He, MD, PhD, Chair Professor of Experimental
Ophthalmology in the School of Optometry and director of the Research Centre
for SHARP Vision at The Hong Kong Polytechnic University in Hong Kong
told Medical News Today.
He is the lead author of
a new study recently published in the journal Heart that found a vascular
“fingerprint” on the retina may also be able to predict a person’s stroke risk
in a less invasive manner than traditional tests.
Identifying
a vascular “fingerprint” in the eye
For this study,
researchers analyzed fundus imagesTrusted Source of the retinas of more than
45,000 participants of the U.K. Biobank study to look for measurable biomarkerTrusted Source indicators
in the blood vessels of the retina.
Upon analysis,
scientists identified a total of 118 measurable retinal vascular indicators, 29
of which were significantly associated with a participant’s first-time stroke
risk, providing a vascular “fingerprint.”
“Vascular ‘fingerprint’
on the retina refers to unique retinal parameters or patterns in an
individual’s retina,” He explained. “Analyzing vascular fingerprints on the
retina across populations can help identify trends and risk factors associated
with stroke.”
Seventeen of the 29 indicators are density
indicators. Researchers found that every change in these indicators was linked
to an increased stroke risk of 10-19%.
Changes to the three
caliber indicators in the “fingerprint” were correlated to a 10-14% increased
stroke risk. Alterations to the complexity and twistedness indicators were
associated with a 10.5-19.5% heightened risk of stroke.
Potential
for less-invasive testing for stroke risk
According to
researchers, the retina vascular “fingerprint” — even when combined with just
age and gender stroke risk factors — was as good as the use of traditional risk
factors alone for predicting future stroke risk.
“Traditional ways (blood
tests) to predict stroke risk are limited by relatively low accuracy,
invasiveness, and high cost,” He said.
“(This)
study underscores the potential of retinal vascular fingerprint analysis as a
powerful tool for stroke risk prediction and prevention, offering a
noninvasive, accessible, and effective method for enhancing current screening
practices. The noninvasive nature of retinal analysis paves the way for easier,
more accessible stroke risk screening, especially in primary care settings.”
— Mingguang He, MD, PhD
“We are planning to use
the same method to conduct risk prediction for other diseases such as heart disease and dementia,”
he added.
The
retina is an extension of the brain
MNT spoke with Alexander Solomon, MD, surgical neuro-ophthalmologist and
strabismus surgeon of Pacific Neuroscience Institute at Providence Saint John’s
Health Center in Santa Monica, CA, about this study.
“While overall, the
findings of this study will be of little surprise to most ophthalmologists,
it’s nice to see a study that formalizes this relationship and starts to really
break down some of the metrics of retinal vasculature that reflect higher risk
changes associated with increased risk of stroke,” Solomon said.
“The
reason the associations between retinal vasculature changes being associated
with stroke is of little surprise is that developmentally speaking, the retina
is actually an extension of the brain. Accordingly, it is made up of a series
of neurons (brain cells) that happen to be sensitive to and
process light, so a retinal exam could always be examining a portion of your
brain.”
— Alexander Solomon, MD
“In addition, we know
these vessels change in response to a variety of systemic vasculopathic
conditions including hyperlipidemia,
hypertension, diabetes, and inflammatory disorders that can all lead to
increased stroke risk. Again, having which features are particularly risky is
certainly useful and fascinating,” Solomon explained.
“Many of the elements of
this ‘fingerprinting’ are things that can be qualitatively appreciated but not
quantitatively measured during your average eye exam. It would likely be both useful and interesting to
make the analysis more readily available to allow eye doctors to counsel their
patients better and likely help to improve the generalizability mentioned
above,” he added.
Need
for noninvasive tests to assess stroke risk
MNT also spoke with Christopher
Yi, MD, a board-certified vascular surgeon at Memorial Orange Coast
Medical Center in Fountain Valley, CA, about this study.
“As a physician working
with patients who suffer from strokes, this is definitely an exciting and
innovative discovery,” Yi said.
“The
discovery of a noninvasive method to predict stroke risk through retinal
vascular ‘fingerprints’ is groundbreaking. It not only offers a practical
approach to early detection but also has the potential to make stroke risk
screening more accessible and less resource-intensive, especially in
underserved communities.”
— Christopher Yi, MD
“Stroke remains a
leading cause of disability and death globally, with many cases linked to
modifiable risk factors. Current risk prediction models rely heavily on
invasive tests like blood draws, ultrasounds, CT scans, and MRIs, which can be
costly and less feasible for large-scale screening,” Yi said.
“A retinal-based approach leverages a noninvasive,
simple diagnostic tool that could integrate seamlessly into routine eye exams,
particularly in primary care settings. By improving early detection, healthcare
providers can intervene sooner to manage risk factors and potentially prevent
strokes,” he continued.
“This research
represents a significant step forward in preventive medicine and offers hope
for reducing the global burden of stroke. It underscores the potential of
interdisciplinary approaches combining ophthalmology, cardiology, and
technology to address complex health challenges,” he added.
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