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Retinal examinations may help assess and prevent cardiovascular events

A study suggests retinal examinations might help assess and prevent strokes and heart attacks, and highlights the need for those diagnosed with macular degeneration to consider lifestyle changes

A study suggests retinal examinations might help assess and prevent strokes and heart attacks, and highlights the need for those diagnosed with macular degeneration to consider lifestyle changes


Angiography of age-related macular degeneration. Picture: Science Photo Library

Age-related macular degeneration (AMD) is a leading cause of loss of vision. It shares many risk factors with cardiovascular disease, including age, high blood cholesterol, hypertension and cigarette smoking.

Previous studies have shown that people with AMD have a higher risk of stroke, coronary heart disease and all-cause mortality. This suggests that the underlying pathological changes in macular degeneration and atherosclerotic cardiovascular disease may be similar.

A recognised method of establishing cardiovascular health is to measure levels of coronary artery calcium, as a high level is known to be a predictor of future cardiovascular events including stroke and heart attack.

This study aimed to see if the presence of AMD could predict the progression of coronary artery calcium. Researchers took photographs of the retinas of 5,803 adults aged 45–84 who were free of known cardiovascular disease. Coronary artery calcium was measured at the start of the study (July 2000-August 2002) and again at the final visit (April 2010-December 2011).

Results and implications for practice

Findings showed there was faster progression of coronary artery calcium in those who also exhibited signs of AMD. This raises the possibility that retinal eye examinations might be a useful tool to assess and prevent cardiovascular events including stroke and heart attack.

It also highlights the need for people diagnosed with macular degeneration to consider lifestyle changes to reduce the risk of cardiovascular problems.


Fernandez A, Ballard K, Wong T et al (2018) Age-related macular degeneration and progression of coronary artery calcium: the Multi-Ethnic Study of Atherosclerosis. PLoS One. 13, 7, e0201000.

About the author

Ruth Sander is an independent consultant in the care of older people

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