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Original Articles
- The distribution of artificial intelligence–derived retinal cardiovascular risk scores and conventional risk factors in two Korean health screening cohorts: a descriptive study
- Jungkyung Cho, Jaewon Seo, Junseok Park, Dongjin Nam, Tae Hyun Park, Sahil Thakur, Tyler Hyungtaek Rim, Beom-hee Choi, Miso Jang
- Cardiovasc Prev Pharmacother. 2025;7(3):73-84. Published online July 28, 2025
- DOI: https://doi.org/10.36011/cpp.2025.7.e14
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Abstract
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Supplementary Material - Background
Although retinal imaging–based artificial intelligence (AI) tools have recently been introduced for cardiovascular disease (CVD) risk assessment, little is known about the distribution of these AI-derived scores across the full age spectrum or their associations with traditional cardiometabolic risk factors at different ages.
Methods
We analyzed data from 138,745 participants who underwent routine health examinations at two health screening centers in Seoul, Korea. The AI-based retinal CVD risk score (Dr.Noon CVD), as well as anthropometric, hemodynamic, and metabolic indices and cardiometabolic disease status, were compared across ages 16 to 96 years. In a subgroup of 13,182 individuals who underwent coronary artery calcium scoring (CACS) by cardiac computed tomography, we evaluated the performance of the Dr.Noon CVD score in detecting CACS using receiver operating characteristic curve analysis.
Results
Mean Dr.Noon CVD scores rose steadily with age from 14.2±2.9 (<30 years) to 46.3±6.5 (≥70 years), closely mirroring the increase in traditional cardiovascular risk factors with age. Additional analysis using CACS demonstrated that the Dr.Noon CVD score achieved an area under the curve of 0.80 (95% confidence interval, 0.80–0.81) for detecting any coronary calcification, defined as CACS >0, and an area under the curve of 0.82 (95% confidence interval, 0.81–0.83) for identifying significant calcification burden, defined as CACS >100.
Conclusions
Dr.Noon CVD scores were consistently correlated with age, conventional risk factors, and CACS, suggesting a potential role in broad-based cardiovascular risk stratification and in guiding personalized prevention strategies.
- Relationship between Retinal Nerve Fiber Layer Defects and Coronary Artery Calcium Score in Patients at Risk for Cardiovascular Disease
- Chan Joo Lee, Joo Youn Shin, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Sungha Park, Suk Ho Byeon
- Cardiovasc Prev Pharmacother. 2021;3(4):95-105. Published online October 31, 2021
- DOI: https://doi.org/10.36011/cpp.2021.3.e11
- 5,397 View
- 36 Download
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Abstract
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- Background
Noninvasive fundus imaging may provide useful information on blood vessels. This study investigated the relationship between localized retinal nerve fiber layer defects (RNFLDs) and vascular biomarkers.
Methods
This study included 1,316 participants without cardiovascular disease who were registered in a cardiovascular high-risk cohort. Examined vascular biomarkers included central hemodynamics, carotid-femoral pulse wave velocity (cfPWV), left ventricular hypertrophy (LVH) on electrocardiogram, and coronary artery calcium score (CACS). Fundus photography and optical coherence tomography were used to evaluate RNFLDs. The associations between RNFLDs and established high-risk cutoff points for each biomarker (central blood pressure [BP] ≥125/80 mmHg, central pulse pressure [PP] ≥50 mmHg, cfPWV ≥10 m/s, presence of LVH, and CACS ≥300) were assessed.
Results
RNFLD was identified in 394 participants (29.9%) who had higher fasting glucose level, lower renal function, and higher BP than those without RNFLDs. Additionally, central BP, central PP, cfPWV, CACS, and the percentage of subjects with LVH were higher in the RNFLD group. After adjusting for confounders, RNFLDs were not associated with LVH or an elevated central BP, central PP, or cfPWV. However, they were associated with an elevated CACS (odds ratio, 1.44; 95% confidence interval, 1.04–2.00; p=0.029).
Conclusions
Non-glaucomatous localized RNFLDs were associated with elevated CACS. Therefore, evaluating RNFLDs using fundus imaging may aid in the assessment of cardiovascular disease risk.
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