Fundus, OCT Images Identify Ocular Disease Biomarkers in UK Biobank Cohort

Color fundus photographs and macular optical coherence tomography (OCT) identified  evidence of age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR) among undiagnosed individuals, according to research published in Eye.

A total of 68,514 participants (mean age, 57.3 years; 47.5% men; 90.6% White) from the UK Biobank were included in the multicenter investigation conducted between 2009 and 2010. A total of 64,367 participants had gradable fundus images for at least 1 eye and 68,281 had gradable OCT images for at least 1 eye. A research team manually graded the images seeking evidence of AMD (≥1 drusen, pigmentary changes, geographic atrophy or exudative AMD; either imaging modality), glaucoma (≥0.7 cup-disc ratio, ≥0.2 cup-disc ratio difference between eyes, other abnormal disc features; photographs only) and retinopathy (characteristic features of diabetic retinopathy with or without microaneurysms; either imaging modality).

Retinal features suggesting AMD were observed in 22.2% of images and those suggesting glaucoma were noted 3.2% of images. Among suspected images, only 0.8% and 8.6% had already been diagnosed with AMD and glaucoma, respectively.

In the subset of individuals with diabetes, 4.8% with microaneurysms had a diagnosis of DR and 5.5% without microaneurysms had DR. Among individuals who did not have diabetes, 0.1% had retinopathy with microaneurysms and 2.2% had retinopathy without microaneurysms.

Stratified by suspected eye diseases, better visual acuity was observed in suspected AMD cases (mean, 0.04 logMAR) and worse visual acuity was observed in suspected retinopathy with microaneurysm cases (mean, 0.14 logMAR; P <.001). Intraocular pressure (IOP) was highest in suspected glaucoma cases (mean, 17.2 mm Hg) and lowest in suspected retinopathy with microaneurysm cases (mean, 15.7 mm Hg; P <.001). Eyes with retinopathy without microaneurysms (spherical equivalent [SE], -1.4 diopters [D]) and glaucoma (SE, -1.8 D) were relatively myopic compared with eyes with suspected AMD (SE, -0.1 D) or retinopathy with microaneurysms (SE, -0.7 D). 

“By focusing on just a few retinal features, we showcase the potential utility of ocular biomarkers that are readily obtainable from non-invasive ophthalmic imaging,” according to the study authors “This formidable data resource promises to accelerate research across a range of areas with relevance to both ocular and associated systemic diseases.”

Study limitations include the use of non-mydriatic single field fundus photography to reduce image acquisition time.

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.