PLOS: Thinning of the retina may indicate a dangerous heart rhythm disorder

Retinal scans may help detect atrial fibrillation several years before it is diagnosed, potentially allowing people at increased risk of stroke to be identified earlier. This is the conclusion reached by researchers from the UCL Institute of Ophthalmology. The findings were published in the journal PLOS Digital Health.

Atrial fibrillation is a heart rhythm disorder in which the heart beats irregularly. The condition does not always cause noticeable symptoms and can be episodic, meaning it may sometimes go undetected during a standard electrocardiogram (ECG). At the same time, AF increases the risk of blood clots that can travel to the brain and cause a stroke.

The researchers analyzed data from 89,664 people from two large studies: 50,651 participants in the AlzEye project and 39,013 people from the UK Biobank. A total of 6,261 participants had already been diagnosed with atrial fibrillation.

They found that people with AF had, on average, thinner retinas. Similar changes were also detected in participants who did not have the condition at the time of the scan but developed it later. Thinner retinal layers were detected, on average, four years before patients were admitted to hospital with atrial fibrillation.

The researchers believe that retinal changes could become an additional signal for identifying people who need more thorough cardiac evaluation. However, eye scans should not replace an ECG, as cardiac testing is used to confirm the diagnosis.

According to the authors, the potential advantage of the method is that retinal imaging is quick and non-invasive. If further studies confirm the findings, routine eye examinations could help identify people at increased risk of atrial fibrillation and related strokes at an earlier stage.