Eyes are windows to the soul, so it’s said. But it may be more accurate to say that your eyes are windows into your heart.
Researchers have revealed a quick, accurate, low cost, non-invasive eye test to gauge your risk of heart disease. It’s all thanks to artificial intelligence (AI).
Although tests already exist to predict a person’s risk of heart attack and stroke, they are in limited use and tests don’t readily exist for analyzing one’s mortality.
To overcome these shortcomings researchers developed a fully automated artificial intelligence-enabled tool called QUARTZ to examine the network of blood vessels in the eye.
Previous research suggests these tiny blood vessels provide an accurate early indicator of circulatory disease, but more thorough testing of the retinal vasculature was needed to see if it really would be of value.
The Largest Study of its Kind
A group of researchers from the United Kingdom applied QUARTZ to scan images of 88,053 adults aged 40 to 69 who were part of the UK Biobank resource. The tool assesses the width of tiny veins and arteries of the retina as well as their curvature. From this data it develops prediction models for heart attack, stroke, and death from circulatory disease.
In addition to Biobank participants, researchers applied the model in a group of 7,411 men and women aged 48 to 92, who took part in another study. This made it the largest population-based study of retinal vasculature ever carried out.
The researchers compared performance of QUARTZ on its own and together with other risk factors - age, smoking status, and medical history - with the commonly used Framingham risk score (FRS) which shows the risk of developing heart disease over the next ten years. The FRS score is based on age, gender, total cholesterol, HDL-cholesterol, systolic blood pressure, and smoking habits.
After a seven-to-nine-year follow-up period there were 327 circulatory disease deaths among the UK Biobank participants and 201 among the other cohort.
An Accurate Predictor of Mortality
The results showed that in men, retinal vascular width, variation in width and curvature emerged as important predictors of death from circulatory disease. In women, they contributed to risk prediction.
For stroke and heart attack, QUARTZ alone performed equally well or better than FRS.
Overall, these predictive models, combining retinal vasculature with age, smoking, and medical history, captured between half and two thirds of circulatory disease deaths in those most at risk. Researchers described this as highly predictive for mortality, concluding, “AI-enabled vasculometry risk prediction is fully automated, low cost, non-invasive and has the potential for reaching a higher proportion of the population in the community because of availability and because blood sampling or sphygmomanometry (blood pressure readings) are not needed.”
How to Get QUARTZ
The test can be carried out by ophthalmologists or trained assessors outside of medical facilities. This will enable individuals at medium to high risk who would otherwise slip under the radar to be identified and sent for further clinical assessment and treatment intervention.
Professor Alicja Rudnicka, who led the study, said: "Retinal vasculature is a microvascular marker, hence offers better prediction for circulatory mortality and stroke compared with heart attack, which is more macrovascular, except perhaps in women.
“It is highly likely to help prolong disease-free status in an ever-aging population with increasing comorbidities and assist with minimizing healthcare costs associated with lifelong vascular diseases.”
While not yet widely available, researchers hope that the QUARTZ retinal scan will soon be accessible to everyone. This is just the beginning of many new tests that researchers are exploring, including an ApoB test, which is a blood test that measures apolipoprotein in your blood. Researchers believe that ApoB is an even more accurate measure of heart health than "bad" LDL cholesterol. Best of all, this test is already available.
