Cardiovascular risk scores predict future development of serious eye diseases

A new study from UCLA Health shows that a cardiovascular risk score already used routinely in primary care can predict who will develop serious eye diseases years later. Researchers found that people with higher cardiovascular risk scores were significantly more likely to develop conditions including age-related macular degeneration, diabetic retinopathy, glaucoma, retinal vein occlusion, and hypertensive retinopathy. The study appears in Ophthalmology.

Why it matters

Millions of Americans lose vision to eye diseases that often go undetected until significant damage has occurred. Early identification of at-risk individuals could enable timely screening and preventive interventions before irreversible vision loss occurs. This study demonstrates that information already collected during routine doctor visits could help identify patients who would benefit from earlier eye exams, potentially preventing blindness in high-risk individuals. The findings offer a practical way to improve eye disease prevention without requiring additional testing or specialized equipment in primary care settings.

What the study did

Researchers analyzed electronic health records from 35,909 adults aged 40 to 79 years who participated in the All of Us Research Program between 2009 and 2015. They calculated each person's Pooled Cohort Equations (PCE) cardiovascular risk score using standard health information including cholesterol levels, blood pressure, smoking status, and diabetes. Participants were categorized into four risk groups: Low (less than 5%), Borderline (5-7.4%), Intermediate (7.5-19.9%), and High (20% or greater). The research team then tracked who developed eye diseases over the following years, adjusting for factors not included in the cardiovascular score such as race (with extended subgroups not in PCE), body mass index, kidney disease, and education level.

What they found

Higher cardiovascular risk was strongly associated with increased likelihood of developing eye diseases. Adults in the High-risk group were 6.2 times more likely to develop age-related macular degeneration, 5.9 times more likely to develop diabetic retinopathy, 4.5 times more likely to develop hypertensive retinopathy, 3.4 times more likely to develop retinal vein occlusion, and 2.3 times more likely to develop glaucoma compared to those in the Low-risk group. The cardiovascular score performed particularly well at predicting diabetic retinopathy, hypertensive retinopathy, and age-related macular degeneration. These associations remained consistent across different follow-up periods ranging from five to seven years.

What's next

The findings suggest that primary care physicians could use cardiovascular risk scores to identify patients who would benefit from referral to eye care specialists for comprehensive screening. Further research is needed to determine the optimal timing and frequency of eye exams for different risk groups, and whether earlier detection and interventions based on cardiovascular risk can actually help prevent vision loss. Implementation studies could help integrate this risk stratification approach into routine primary care workflows and electronic health record systems.

From the experts

"We found that a simple score already calculated in millions of doctor visits each year may meaningfully predict who will develop serious eye diseases," said Dr. Anne L. Coleman, senior author of the study and chair of the Department of Ophthalmology at UCLA Health. "This gives us an opportunity to identify high-risk patients early, when preventive measures might still protect their vision. The beauty of this approach is that it requires no additional testing; the information is already there in the medical record."