{
  "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. Author summary: Atrial fibrillation, one of the most common heart conditions causing an irregular heart rhythm, affects millions of people worldwide and significantly increases the risk of stroke and heart failure. Detecting it early, before symptoms arise, remains a major clinical challenge. In this study, we explored whether the retina could offer clues about a person’s cardiac health. Because the retina shares structural and vascular similarities with the brain and heart, changes visible on routine eye scans may reflect broader changes occurring elsewhere in the body. Using eye imaging data from over 90,000 individuals across two large independent datasets, we found that people with atrial fibrillation show measurable thinning of specific inner retinal layers, the ganglion cell and inner plexiform layer, and the inner nuclear layer, compared to those without atrial fibrillation. Crucially, individuals with a thinner retina at baseline were significantly more likely to develop atrial fibrillation in the future, even before any cardiac diagnosis had been made, underlining the difficulty of establishing the diagnosis. These findings suggest that standard, non-invasive retinal scans which are widely used both in eye clinics and community settings, could potentially help identify individuals at elevated cardiac risk, potentially enabling earlier intervention and improved outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "NIHR Moorfields Biomedical Research Centre, London, United Kingdom",
    "Institute of Ophthalmology, University College London, London, United Kingdom",
    "Department of Ophthalmology and Optometry, Kepler University Hospital, Linz, Austria",
    "NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom",
    "Department of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom",
    "Department of Brain Repair and Rehabilitation, Stroke Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom",
    "The National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, United Kingdom",
    "Pediatric Cardiology, Pediatric Heart Center, University Children’s Hospital Zurich, Switzerland",
    "William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom",
    "Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom",
    "MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom",
    "Rothschild Foundation Hospital, Paris, France",
    "Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong",
    "UCL Great Ormond Street Institute of Child Health, London, United Kingdom",
    "Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom",
    "Ulverscroft Vision Research Group, UCL London, London, United Kingdom",
    "Julius Center, University Medical Center Utrecht, the Netherlands"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Josef Huemer"
    },
    {
      "affs": [
        1
      ],
      "name": "Kelsey V. Stuart"
    },
    {
      "affs": [
        2
      ],
      "name": "Yukun Zhou"
    },
    {
      "affs": [
        3
      ],
      "name": "Dominic J. Williamson"
    },
    {
      "affs": [
        4
      ],
      "name": "Peter Woodward-Court"
    },
    {
      "affs": [
        5
      ],
      "name": "Alastair R. Mobley"
    },
    {
      "affs": [
        6
      ],
      "name": "Arvind Chandratheva"
    },
    {
      "affs": [
        7
      ],
      "name": "Florian Berger"
    },
    {
      "affs": [
        8
      ],
      "name": "Nay Aung"
    },
    {
      "affs": [
        9
      ],
      "name": "Steffen E. Petersen"
    },
    {
      "affs": [
        10
      ],
      "name": "UK Biobank Eye and Vision Consortium"
    },
    {
      "affs": [
        11
      ],
      "name": "Anthony P. Khawaja"
    },
    {
      "affs": [
        12
      ],
      "name": "Axel Petzold"
    },
    {
      "affs": [
        13
      ],
      "name": "Jugnoo Rahi"
    },
    {
      "affs": [
        14
      ],
      "name": "Alastair K. Denniston"
    },
    {
      "affs": [
        15
      ],
      "name": "Dipak Kotecha"
    },
    {
      "affs": [
        16
      ],
      "name": "Pearse A. Keane"
    },
    {
      "name": "Praveen J. Patel"
    },
    {
      "name": "Siegfried K. Wagner"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6rz7t3xts2w30.bib",
  "cited_by": 1,
  "doi": "10.1371/journal.pdig.0001661",
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  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "native_subjects": [
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  "pmcid": null,
  "pmid": null,
  "published": "2026-09-10",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/6rz7t3xts2w30.ris",
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    {
      "first_seen": "2026-10-30T12:17:56Z",
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  "title": "Atrial fibrillation and retinal imaging-based oculomics: A cross-sectional and longitudinal analysis of two large cohorts",
  "title_text": "Atrial fibrillation and retinal imaging-based oculomics: A cross-sectional and longitudinal analysis of two large cohorts",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:56Z",
  "url": "https://research.draconitic.com/paper/6rz7t3xts2w30",
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