ArticleBMC medicine2023
Retinal nerve fiber layer thinning as a novel fingerprint for cardiovascular events: results from the prospective cohorts in UK and China.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 26 citations in OpenAlex.
- Retinal layer thickness as a potential marker for future cardiovascular events - a UK Biobank cohort study using optical coherence tomography.Journal of neurology · 2026Article
- Impact of Continuous Positive Airway Pressure Treatment on Retinal Vasculature in Obstructive Sleep Apnea: A 7-Year Follow-Up.Investigative ophthalmology & visual science · 2026Article
- A deep learning algorithm for coronary heart disease prediction based on retinal fundus photographs and optical coherence tomography.BMC medical imaging · 2026Article
- The value of retinal microvascular features in predicting risk stratification and long-term prognosis of patients with acute coronary syndrome.BMC ophthalmology · 2026Article
- Neuroretinal and Photoreceptor Layer Thickness Reduction Associates With Impaired Cardiovascular Health: The UK Biobank Study.Investigative ophthalmology & visual science · 2026Article
- Article
- Artificial intelligence-driven metabolomics of retinal nerve fibre layer to profile risks of mortality and cardiometabolic diseases.Nature communications · 2025Article
- Retinal and Choroidal Alterations in Heart Failure: A Systematic Review and Meta-analysis of OCT and OCT-A Findings with Emphasis on HFrEF.Ophthalmology and therapy · 2025Review
- Retinal Imaging as a Window into Cardiovascular Health: Towards Harnessing Retinal Analytics for Precision Cardiovascular Medicine.Journal of cardiovascular development and disease · 2025Review
- Comparison of AI-Automated and Manual Subfoveal Choroidal Thickness Measurements in an Elderly Population Using Optical Coherence Tomography.Translational vision science & technology · 2025Article
- The Use of Retinal Imaging Including Fundoscopy, OCT, and OCTA for Cardiovascular Risk Stratification and the Detection of Subclinical Atherosclerosis.Current atherosclerosis reports · 2025Review
- Causal Effects Between Retinal Characteristics and Cardiovascular Diseases: Insights from Genetic Correlation, Mendelian Randomization, and Cross-Sectional Study.Global heart · 2025Article
- Predicting cardiovascular disease risk using retinal optical coherence tomography imaging.Frontiers in artificial intelligence · 2025Article
- A cross-sectional study on the impact of hemodialysis duration on retinal nerve fiber layer thinning in hemodialysis patients.Scientific reports · 2024Article
- PallorMetrics: Software for Automatically Quantifying Optic Disc Pallor in Fundus Photographs, and Associations With Peripapillary RNFL Thickness.Translational vision science & technology · 2024Article
- Association between optic disc pallor and lacunar stroke.BMJ neurology open · 2024Article
- Retinal Findings and Cardiovascular Risk: Prognostic Conditions, Novel Biomarkers, and Emerging Image Analysis Techniques.Journal of personalized medicine · 2023Review
- Evaluation of optical coherence tomography in patients with coronary artery disease and systemic hypertension.Oman journal of ophthalmologyArticle
- Article
- Retinal nerve fibre layer thickness reflects characteristics of brain grey and white matter.Imaging neuroscience (Cambridge, Mass.)Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundRetinal structural abnormalities have been found to serve as biomarkers for cardiovascular disease (CVD). However, the association between retinal nerve fiber layer (RNFL) thickness and the incidence of CVD events remains inconclusive, and relevant longitudinal studies are lacking. Therefore, we aimed to examine this link in two prospective cohort studies.
methodsA total of 25,563 participants from UK Biobank who were initially free of CVD were included in the current study. Another 635 participants without retinopathy at baseline from the Chinese Guangzhou Diabetes Eye Study (GDES) were adopted as the validation set. Measurements of RNFL thickness in the macular (UK Biobank) and peripapillary (GDES) regions were obtained from optical coherence tomography (OCT). Adjusted hazard ratios (HRs), odd ratios (ORs), and 95% confidence intervals (CI) were calculated to quantify CVD risk.
resultsOver a median follow-up period of 7.67 years, 1281 (5.01%) participants in UK Biobank developed CVD events. Each 5-μm decrease in macular RNFL thickness was associated with an 8% increase in incident CVD risk (HR = 1.08, 95% CI: 1.01-1.17, p = 0.033). Compared with participants in the highest tertile of RNFL thickness, the risk of incident CVD was significantly increased in participants in the lowest thickness tertile (HR = 1.18, 95% CI: 1.01-1.38, p = 0.036). In GDES, 29 (4.57%) patients developed CVD events within 3 years. Lower average peripapillary RNFL thickness was also associated with a higher CVD risk (OR = 1.35, 95% CI: 1.11-1.65, p = 0.003). The additive net reclassification improvement (NRI) was 21.8%, and the absolute NRI was 2.0% by addition of RNFL thickness over the Framingham risk score. Of 29 patients with incident CVD, 7 were correctly reclassified to a higher risk category while 1 was reclassified to a lower category, and 21 high risk patients were not reclassified.
conclusionsRNFL thinning was independently associated with increased incident cardiovascular risk and improved reclassification capability, indicating RNFL thickness derived from the non-invasive OCT as a potential retinal fingerprint for CVD event across ethnicities and health conditions.
trial registrationISRCTN 15853192.
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