Atrial fibrillation and retinal imaging-based oculomics: A cross-sectional and longitudinal analysis of two large cohorts.

Authors

Josef Huemer, Kelsey V Stuart, Yukun Zhou, Dominic J Williamson, Peter Woodward-Court, Alastair R Mobley, Arvind Chandratheva, Florian Berger, Nay Aung, Steffen E Petersen, UK Biobank Eye and Vision Consortium, Anthony P Khawaja, Axel Petzold, Jugnoo Rahi, Alastair K Denniston, Dipak Kotecha, Pearse A Keane, Praveen J Patel, Siegfried K Wagner

Published in

PLOS digital health. Volume 5. Issue 9. Pages e0001661. Epub Sep 10, 2026.

Abstract

We investigate the association between multimodal retinal imaging parameters with prevalent and incident atrial fibrillation (AF). For this cross-sectional and longitudinal analysis we utilized data from two independent cohorts: AlzEye (retrospective, age ≥ 40 years, 2008-2018) and UK Biobank (UKB; prospective, age 40-69 years, recruited 2006-2010). Retinal sublayer thicknesses and retinovascular indices were extracted from macular optical coherence tomography and color retinal photography, respectively. AF was ascertained via self-report and hospital admissions, association between retinal metrics with prevalent and incident AF were estimated using mixed-effects linear and frailty models. In AlzEye (n = 50,651), prevalent AF (n = 5,375; 11%) was associated with significantly smaller retinal venular calibre (-0.05 µm, 95% CI: -0.08, -0.03) and thinner macular retinal nerve fibre layer (-0.69 µm, 95% CI: -0.91, -0.46), ganglion cell-inner plexiform layer (mGCIPL; -1.96 µm, 95% CI: -2.34, -1.58), inner nuclear layer (-0.57 µm, 95% CI: -0.75, -0.38), and photoreceptor layer (-0.93 µm, 95% CI: -1.38, -0.48). Venular fractal dimension was lower (-0.08, 95% CI: -0.11, -0.06), while arteriolar fractal dimension was higher (0.05, 95% CI: 0.02, 0.08) in individuals with AF. Evidence of thinner mGCIPL was replicated in UKB (-1.19 µm, 95% CI: -1.73, -0.65). In UKB (n = 39,013 baseline without AF), 838 developed AF over a mean of 4.0 years. Adjusting for sociodemographic, clinical and lifestyle factors, each SD decrease in mGCIPL thickness was associated with a significant 27% increased hazard of AF (95% CI: 5%, 54%). Differences in the inner retinal sublayers, corresponding to retinal ganglion cells, are associated with prevalent and incident AF across two large independent cohorts, supporting the potential role of widely-accessible retinal imaging for early detection and better management of AF.

PMID:
42721194
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.

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