Retina May Signal AFib Up to 4 Years Before Diagnosis
Baca dalam 60 detik
- Pemeriksaan OCT pada retina mengungkap penipisan lapisan mGCIPL yang konsisten pada penderita fibrilasi atrium, bahkan empat tahun sebelum gejala muncul.
- Temuan ini membuka peluang skrining berbasis optometri untuk mendeteksi risiko gangguan irama jantung tanpa prosedur invasif.
- Tantangan berikutnya adalah validasi lintas populasi dan integrasi ke dalam alur rujukan kardiologi di layanan primer.
A recent study published in the journal PLOS Digital Health reveals that subtle changes in the eye's retinal layers can serve as an early marker for atrial fibrillation (AFib), a heart rhythm disorder often missed during detection. The research, which analyzed over 90,000 retinal images from two large cohorts, AlzEye and UK Biobank, found that individuals later diagnosed with AFib had a thinner macular ganglion cell–inner plexiform layer (mGCIPL) an average of four years before they presented to the hospital with heart-related complaints.
Atrial fibrillation affects approximately 52.55 million people worldwide and increases the risk of stroke, heart failure, heart attack, and even dementia. However, about 62% of those affected are unaware of their condition before diagnosis. The absence of typical symptoms often means AFib is only detected after causing serious complications. Therefore, this finding is considered a potential breakthrough for accelerating the identification of high-risk groups.
Lead researcher Josef Huemer, an ophthalmologist at Moorfields Eye Hospital and a researcher at University College London, explained that the retina is the only part of the body where blood vessels and nerve tissue can be analyzed non-invasively through OCT scans or fundus photography. “The thinning of the mGCIPL is likely caused by mini-strokes in the brain, a common finding in AFib patients. However, because it was consistent across both cohorts—hospital patients and healthy volunteers—we are quite confident in these results,” he stated.
Huemer added that his team also found thinning of the inner nuclear layer, suspected to be due to cardiovascular disease, as this area is susceptible to micro-strokes in the eye. “The next step is to explore whether these findings can improve risk calculations and refer patients earlier for long-term electrocardiogram monitoring,” Huemer said. He and his team are currently developing oculomics algorithms to be submitted as medical devices, targeting their use in local optometry for early detection of systemic diseases.
Benjamin Bert, an ophthalmologist at MemorialCare Orange Coast Medical Center not involved in the study, hypothesized that AFib could trigger “silent ischemia”—brief episodes of poor blood perfusion that damage tissue and lead to thinning of the retinal layers. “This could also be related to mild damage to the brain that results in cellular atrophy in the retina,” he added.
Meanwhile, Cheng-Han Chen, an interventional cardiologist at MemorialCare Saddleback Medical Center, believes this approach has the potential to expand the ability to detect AFib risk earlier. “The mechanisms linking AFib to changes in eye cells or blood vessels are not yet well understood. We typically don't associate heart rhythm disorders with changes in eye cells, so this connection is very interesting and warrants further investigation,” Chen explained. He emphasized that future studies must determine the specific biological changes in the eye associated with AFib and whether these findings can reliably predict it.
“At this stage, these findings are promising but should be viewed as an initial step towards understanding the potential connection between the heart and the eye.” — Cheng-Han Chen, MD
For Indonesia, these findings open opportunities to strengthen early detection of cardiovascular diseases through optometry services already available in major cities. With high prevalence of hypertension and diabetes, the risk of AFib in the country is also significant. If OCT scans can be integrated into routine screenings, especially in primary healthcare facilities, early detection costs could be reduced, and referrals to cardiology would become more targeted. However, challenges remain: the availability of OCT devices in community health centers (puskesmas) and regional eye clinics is still limited, and there is a need for training healthcare professionals to consistently interpret the results.
Looking ahead, the key question is no longer whether the eye can be a window into heart health, but rather how quickly these findings can be validated in Asian populations and adopted as a routine screening tool. If successful, eye examinations, which have long been synonymous with eyeglasses, could transform into a frontline defense against stroke and heart failure.
