- New research looks into how the retina and vascular system are connected.
- Retinal blood vessels can act like a window into heart health and overall health, including lifespan and aging markers, a study found.
- Experts weigh in on the findings and what it may mean for your health.
All bodily systems are connected and help inform one another; some link in ways that may surprise you. A new study highlights the under-discussed relationship between your eyes and heart, and how the retina and vascular systems, in particular, may indicate overall health, aging markers, and lifespan.
Meet the Experts: Jacqueline Bowen, O.D., president of the American Optometric Association; Sergiu Darabant, M.D., cardiologist at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida; Benjamin Bert, M.D., board-certified ophthalmologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA; and Ferhaan Ahmad, M.D., Ph.D., director of the Cardiovascular Genetics Program at the University of Iowa.
The study was published in ScienceAdvances in October and looked at retinal imaging and genetic data from over 74,000 people and explored how their networks of tiny retinal blood vessels—also known as the retinal microvasculature—may be a “window into the body’s circulatory system,” explains Jacqueline Bowen, O.D., president of the American Optometric Association, that could help doctors predict, detect, prevent, and treat heart disease.
Researchers found that people with a “simpler” or less branched microvasculature tracks with more inflammation, higher risk of heart disease and stroke, and shorter lifespan, explains Sergiu Darabant, M.D., cardiologist at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida. Why? Simple retinal blood vessels are “less resilient and can signal reduced blood flow or damage, which may be a warning sign for conditions that affect the circulatory system,” says Dr. Bowen.
Conversely, people with more complex, branchy tree-like vessels tended to live longer and have healthier hearts and more adaptive vascular systems, Dr. Bowen adds. Researchers also pinpointed specific genes and blood proteins, specifically MMP12 and the IgG-Fc receptor IIb, that likely play a part in these outcomes by contributing to inflammation that comes with aging.
In short, the findings demonstrate “the power of using the retinal microvasculature to diagnose other systemic diseases,” says Benjamin Bert, M.D., board-certified ophthalmologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.
What are MMP12 and IgG-Fc receptor IIb proteins?
These proteins are known to contribute to chronic, low-grade inflammation that comes with age, also known as “inflammaging,” per Dr. Bowen, which raises risk for many age-related diseases. “Specifically, MMP12 helps regulate tissue remodeling but can also contribute to age-related damage in blood vessels, while IgG-Fc receptor IIb is tied to immune and inflammatory processes that influence how we age,” Dr. Bowen says.
Studies have shown that inflammation “can accelerate damage to arteries and lead to heart attacks, peripheral artery disease, and strokes,” explains Ferhaan Ahmad, M.D., Ph.D., director of the Cardiovascular Genetics Program at the University of Iowa. “It is possible that treatments directly working on these proteins may improve cardiovascular health. However, considerable research remains to be conducted to validate these proteins as targets for treatment.”
How may eye and heart health be connected?
The retina is the only place in the body where blood vessels can be non-invasively, directly seen and measured without the need for a biopsy, our experts say, and it houses the same network of blood vessels (a.k.a. vasculature) that are in the brain and the kidneys, which can tell a lot about a person’s health. “For that reason, dilated eye exams [where doctors use eye drops to expand the pupil and make the eye structure more visible] have, for years, provided a way to examine this vasculature and allow clinicians to diagnose patients with underlying cardiovascular diseases like diabetes or hypertension,” explains Dr. Bert.
Because the eye’s blood vessels reflect what’s happening elsewhere, studying them also helps optometrists spot early signs of metabolic changes linked to diseases affecting the endocrine, autoimmune, neurological, and other systems, says Dr. Bowen.
Also, it’s worth noting that the retinal arteries are exposed to the same stresses as the rest of the blood vessels in the body, Dr. Ahmad adds. Therefore, their health status usually reflects the health of the rest of the blood vessels in the body.
The bottom line
Don’t skip your annual eye exams—for the health of your vision and, potentially, your heart and other vital systems. “Optometrists can detect more than 270 serious health conditions and identify personalized prevention plans to help patients improve health outcomes,” says Dr. Bowen. Dilation and advanced retinal imaging may be an excellent way to evaluate for hypertension, diabetes, cholesterol, and other conditions. Plus, it’s a great preventative health care tool to embrace. “Because the images can be stored and compared over time, they allow optometrists to monitor subtle changes and detect issues earlier,” Dr. Bowen says.
