A routine eye scan might reveal more than whether or not someone needs glasses. It could also help doctors spot signs of osteoporosis years before a broken bone ever happens.
It might seem like an unlikely connection. But the retina — the light-sensitive tissue at the back of the eye — may also reflect how the rest of the body is aging, including parts that seem completely unrelated to vision, like the skeleton.
In a new study published in PLOS Digital Health, researchers found that people whose retinas appeared biologically “older” were more likely to have lower bone density, higher fracture risk, and a greater chance of developing osteoporosis later in life.
Osteoporosis affects nearly 20 percent of people globally and is often called a silent disease because many people do not realize their bones are weakening until they suffer a fracture. The standard screening test, known as a DEXA scan, can also be expensive and difficult to access for people who do not yet appear to be high risk. Researchers say retinal scans could someday help flag osteoporosis risk earlier and more easily.
Using AI To Predict Osteoporosis Risk From Retinal Scans
Concept image showing an AI retinal scan
(Image Credit: Singapore Eye Research Institute Research Clinic team. Dr. Kenon Chua. Dr. Qingsheng Peng. CC-BY 4.0)
To explore the connection, researchers used an artificial intelligence tool called RetiAGE. The system analyzes retinal photographs and estimates whether someone’s eyes appear biologically older than expected.
The team first tested the system using nearly 2,000 older adults in Singapore who had both retinal scans and bone density measurements taken on the same day. People whose retinas appeared biologically older tended to have weaker bones in several parts of the hip and femur. They also had higher fracture risk scores.
But the team wanted to know whether the eyes were simply reflecting existing bone loss or might actually predict future problems years before osteoporosis develops.
So they turned to nearly 44,000 U.K. Biobank participants who did not have osteoporosis at the start of the study. Over roughly 12 years of follow-up, people with older-looking retinas were more likely to develop osteoporosis later on. Those in the highest retinal-aging group faced roughly 40 percent higher risk than those in the lowest group.
The pattern remained even after researchers accounted for many of the usual osteoporosis risk factors, including age, smoking, physical activity, diabetes, hypertension, menopause, and body weight.
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Why Would The Eyes And Bones Be Connected?
At first glance, the retina and skeleton do not seem to have much in common. But researchers say both tissues appear to respond to many of the same long-term stresses tied to aging.
Inflammation, poor circulation, and metabolic disease can slowly damage the tiny blood vessels in the retina and contribute to bone loss over time. Physical activity and sun exposure (both important for maintaining healthy bones) are also known to influence retinal health.
The researchers also found genetic overlap between retinal aging and osteoporosis risk. One gene highlighted in the study, called IRF4, appears to play a role in both retinal inflammation and bone remodeling.
Osteoporosis Warning Signs Could One Day Show Up In Eye Exams
The eye may tell us a lot more about overall health than we once realized. Previous studies have already linked retinal aging to conditions including cardiovascular disease, Parkinson’s disease, and chronic kidney disease.
And unlike traditional bone scans, retinal imaging is already common in many eye clinics and diabetes screenings, meaning the technology is already sitting in doctors’ offices.
Now, researchers think osteoporosis may belong on that growing list, too. A quick photograph of the back of the eye may someday help uncover whether someone’s bones are becoming more fragile before symptoms appear.
This article is not offering medical advice and should be used for informational purposes only.
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