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Retinal examination can predict heart attack risk

Routine eye screening combined with genetic data could offer insight into individual’s heart health and risk of illness.

Assessing blood vessel patterns in a person’s retina in combination with details of their genetic data can enable accurate prediction of their risk of coronary heart disease and heart attack, according to Roslin research.

The discovery could inform development of a simple screening process where heart attack risk could be calculated when a person undergoes a routine eye test, according to research presented at the annual conference of the European Society of Human Genetics.

Scientists studied branching patterns of retinal blood vessels by calculating a measure named fractal dimension (Df), using data available from the UK Biobank, a health study that includes demographical, epidemiological, clinical, imaging and genotyping data from more than 500,000 participants across the UK.

The researchers developed a model that was able to predict heart attack risk by studying data relating to Biobank participants who had experienced a heart attack after collection of their retinal images.

The model included fractal dimension as well as traditional clinical factors, such as age, sex, blood pressure, body mass index and smoking status, to calculate personalised heart attack risk.

Improved accuracy

The resulting model was able to better classify Biobank participants with low or high risk of heart attack than established models that include only demographic data. It was further improved with inclusion of a score related to the genetic propensity of developing heart attack, researchers found.

Investigation of the genetics of Df found nine genetic regions that were discovered to be driving retinal blood vessel patterns, four of which are known to be involved in cardiovascular disease genetics, including processes related to heart attack severity and recovery.

These findings may also be useful in identifying propensity to other diseases. Variations in the retinal vascular pattern also reflect the development of other ocular and systemic diseases, such as sight loss linked to diabetes, and stroke. The researchers believe it is possible that every condition may have a unique retinal variation profile, and hope to investigate this further, as well as undertaking a sex-specific analysis.

Results suggest that a simple retinal examination in people aged 50 and over may be able to provide enough information to identify people at risk of heart attack.

We already knew that variations in the vasculature of the retina might offer insights into our health. We found that simplified vessel branching patterns is related to coronary disease and hence heart attack. Our work once more shows the importance of comprehensive analysis of data that is routinely collected and its value in the further development of personalised medicine.

Ana Villaplana-VelascoPhD student, Usher Institute and Roslin Institute

** The Roslin Institute receives strategic investment funding from the Biotechnology and Biological Sciences Research Council and it is part of the University of Edinburgh’s Royal (Dick) School of Veterinary Studies. **

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