Eye scans could help detect a common heart condition years before it is diagnosed, a study has found.
Researchers said the approach could be a non-invasive way to flag atrial fibrillation (AF) before it “causes real harm”.
Experts analysed data from more than 90,000 people and found those with the condition had distinctive biomarkers in their retina, the light-sensitive layer of tissue in the eye that detects light and converts it into signals for the brain.
Around 1.5 million people in the UK are estimated to have AF, which brings about an irregular heartbeat, though hundreds of thousands more may be living undiagnosed.
AF sometimes presents without symptoms and is intermittent, meaning it can be missed during diagnostic heart checks known as electrocardiograms (ECGs).
Although the condition is not directly life-threatening, it can produce blood clots that lead to strokes.
Researchers at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology looked at data from 50,651 taking part in the AlzEye study and 39,013 people from the UK Biobank. In total, some 6,261 patients already had AF.
The analysis found that these people tended to have thinner retinal layers.
Patients who did not have AF at the time their eye scans were taken but went on to develop the condition also had thinner retinal layers four years prior to attending hospital on average.
Moorfields patient John Brewer, from Croydon, discovered he had AF while having surgery to remove cataracts earlier this year.
Symptoms of atrial fibrillation
NHS
The main symptoms of atrial fibrillation are:
- an irregular heartbeat, where your pulse is not steady
- suddenly feeling like your heart is pounding, racing, fluttering, skipping or missing a beat (heart palpitations) – this may last for a few seconds up to a few minutes
- a heartbeat faster than 100 beats per minute
- feeling very tired
- finding it harder to exercise
- chest pain or tightness
- feeling short of breath, lightheaded, dizzy or like you might faint
When the team noticed his heartbeat was unsteady, he was given an ECG and medicine to allow the operation to continue, and a cardiologist later confirmed the diagnosis.
Mr Brewer said: “It would have been so much easier if my AF had been detected earlier through a routine retinal scan at one of my regular appointments, rather than on the operating table, which was a very distressing experience for my wife and I.”
Experts suggest that while eye scans would not replace ECGs to diagnose AF, they could be a “complementary tool”.
Siegfried Wagner, of UCL, said: “This large-scale analysis shows that retinal imaging can pick up on structural changes within the eye that are clearly linked to AF.
“For patients, the value of this kind of eye imaging is that it is easy to access, quick and doesn’t involve any invasive procedures.
“Although not intended to replace ECG-based diagnosis, retinal imaging could act as a complementary tool, catching those most at risk of AF before it causes real harm.”
Lead author Josef Huemer, consultant ophthalmologist at Moorfields Eye Hospital, said: “If confirmed in further research, our findings raise the possibility that routine eye examinations could, in future, help identify people who would benefit from closer cardiac assessment, potentially enabling earlier treatment with therapies known to reduce the risk of stroke.”
The findings have been published in the journal, Plos Digital Health.
