The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes

Alatrany, AS ORCID: 0000-0002-4504-1506, Lakhani, K, Cowley, AC, Yeo, JL, Dattani, A, Ayton, SL, Deshpande, A, Graham-Brown, MPM, Davies, MJ, Khunti, K, Yates, T, Sellers, SL, Zhou, H, Brady, EM, Arnold, JR, Deane, J, McLean, RJ, Proudlock, FA, McCann, GP and Gulsin, GS (2025) The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes. Scientific Reports, 15 (1). ISSN 2045-2322

Preview

Text The retina as a window into detecting subclinical cardiovascular disease in type 2 diabetes.pdf - Published Version Available under License Creative Commons Attribution. Download (2MB) | Preview

Abstract

Individuals with Type 2 Diabetes (T2D) are at high risk of subclinical cardiovascular disease (CVD), potentially detectable through retinal alterations. In this single-centre, prospective cohort study, 255 asymptomatic adults with T2D and no prior history of CVD underwent echocardiography, non-contrast coronary computed tomography and cardiovascular magnetic resonance. Retinal photographs were evaluated for diabetic retinopathy grade and microvascular geometric characteristics using deep learning (DL) tools. Associations with cardiac imaging markers of subclinical CVD were explored. Of the participants (aged 64 ± 7 years, 62% males); 200 (78%) had no diabetic retinopathy and 55 (22%) had mild background retinopathy. Groups were well-matched for age, sex, ethnicity, CV risk factors, urine microalbuminuria, and serum natriuretic peptide and high-sensitivity troponin levels. Presence of retinopathy was associated with a greater burden of coronary atherosclerosis (coronary artery calcium score ≥ 100; OR 2.63; 95% CI 1.29–5.36; P = 0.008), more concentric left ventricular remodelling (OR 3.11; 95% CI 1.50–6.45; P = 0.002), and worse global longitudinal strain (OR 2.32; 95% CI 1.18–4.59; P = 0.015), independent of key co-variables. Early diabetic retinopathy is associated with a high burden of coronary atherosclerosis and markers of early heart failure. Routine diabetic eye screening may serve as an effective alternative to currently advocated screening tests for detecting subclinical CVD in T2D, presenting opportunities for earlier detection and intervention.

Item Type:	Article
Uncontrolled Keywords:	Atherosclerotic coronary artery disease; Cardiovascular disease; Diabetic cardiomyopathy; Digital retinal photography; Heart failure.; Type 2 diabetes; 32 Biomedical and Clinical Sciences; 3212 Ophthalmology and Optometry; Atherosclerosis; Biomedical Imaging; Cardiovascular; Diabetes; Heart Disease; Prevention; Aging; Eye Disease and Disorders of Vision; Heart Disease - Coronary Heart Disease; 4.2 Evaluation of markers and technologies; 4.1 Discovery and preclinical testing of markers and technologies; Eye; Metabolic and endocrine; Cardiovascular; 3 Good Health and Well Being
Subjects:	Q Science > QA Mathematics > QA75 Electronic computers. Computer science
Divisions:	Computer Science and Mathematics
Publisher:	Springer Nature
Date of acceptance:	24 July 2025
Date of first compliant Open Access:	29 August 2025
Date Deposited:	29 Aug 2025 15:28
Last Modified:	29 Aug 2025 15:30
DOI or ID number:	10.1038/s41598-025-13468-4
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27060

View Item