Difference between biological age of retina and a person's chronological age is associated with increased risk of death

A study published on the website of the British Journal of Ophthalmology found the difference between the biological age of the retina (the layer of light-sensitive nerve tissue at the back of the eye) and a person's chronological age (chronological age).

The researchers suggest that this "retinal age gap" could serve as a screening tool

Growing evidence suggests that the network of small blood vessels (microvasculature) in the retina may be a reliable indicator of the body's circulatory system and overall brain health

While the risks of illness and death increase with age, it is clear that these risks vary widely among people of the same age, meaning that "biological aging" is unique to individuals, the researchers said.

Several tissue, cellular, chemical, and imaging-based indicators have been developed to detect biological aging that is out of sync with chronological aging

So they turned to whether deep learning could accurately predict the age of a person's retinal fundus image, after the inner surface of the eye, to see if there was a difference between a person's true age, known as the retinal age gap, that could lead to a high risk of death

Deep learning is a type of machine learning and artificial intelligence (AI) that mimics the way people acquire certain types of knowledge

The researchers collected 80,169 fundus images from 46,969 adults aged 40 to 69 who were members of the UK Biobank, a large population-based study of 50 people.

In the initial Biobank health check, approximately 19,200 right-eye fundus images from 11,052 relatively healthy participants were used to validate the accuracy of the deep learning model in predicting retinal age

This indicates a strong correlation between predicted retinal age and chronological age, with an overall accuracy within 3.

Retinal age gaps were then assessed for the remaining 35,917 participants during an average monitoring period of 11 years

During this period, 1871 (5%) died: 321 (17%) from cardiovascular disease; 1018 (54.

The percentages of "fast old people" (those whose retinas appear older than their actual age) had retinal age gaps of more than 3, 5 and 10 years, respectively, were 51%, 28% and 4.

Except for cardiovascular disease or cancer, a larger retinal age gap was significantly associated with a 49%-67% increased risk of death

For every 1-year increase, the retinal age gap was associated with a 2% increased risk of death from any cause and a 3% increased risk of death from specific causes other than cardiovascular disease and cancer, after accounting for underlying contributing factors such as hypertension, body weight (BMI) , life>

The same method applied to the left eye produced similar results

This is an observational study and cannot establish cause
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The researchers also acknowledged that these retinal images were captured at one point in time and that the participants may not be representative of the entire UK population
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However, they write: "Our new findings have established that retinal age gap is an independent predictor of increased risk of death, particularly non-cardiovascular/non-cancer mortality
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These findings suggest that retinal age may be a clinically meaningful Significant biomarkers of aging
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They added: "The retina provides a unique, accessible 'window' to assess the underlying pathological processes in systemic vascular and neurological disease associated with increased risk of death
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"This hypothesis is supported by previous studies showing that retinal imaging contains information on cardiovascular risk factors, chronic kidney disease and systemic biomarkers
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They explain that the new findings, combined with previous research, add weight to the hypothesis that "the retina plays an important role in the aging process and is sensitive to the cumulative damage of aging that increases the risk of death
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article title

Clinical Science: Retinal age gap as a predictive biomarker for mortality risk