A101-11 Retinal Biomarkers and Chronic Obstructive Pulmonary Disease

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Abstract Introduction Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) share systemic inflammatory pathways and COPD is associated with increased CV risk. Retinal imaging offers a non-invasive window into microvascular and central nervous system changes. We investigated retinal anatomy, measured using optical coherence tomography (OCT) and colour fundus photography in COPD and subsequently assessed these markers’ discriminative ability to identify COPD. Methods This analysis used data from AlzEye study to explore retinal morphology in COPD. AlzEye is a retrospective cohort of 353,157 patients aged 40 years and older attending secondary care ophthalmic hospitals in London, United Kingdom, between 2008 and 2018. Nerve fibre layer (NFL), ganglion cell inner plexiform layer (GCIPL), inner nuclear layer (INL), and outer nuclear plexiform layer (ONPL) thicknesses were extracted from fovea-centred OCT. Vessel width, arteriovenular ratio (AVR), and vessel tortuosity density were extracted from colour fundus photography. Linear mixed-effect models were fitted to examine the association between COPD and retinal biomarkers. Logistic regression models were used to assess the discriminative ability of the retinal biomarkers to identify COPD. Results Within the AlzEye cohort, there were 7,878 individuals with COPD and 69,459 controls (median age 84 and 81 years, respectively), 52.5% and 47.9% male respectively. Individuals with COPD had thinner GCIPL, NFL, INL, and ONPL; increased vessel width; decreased arteriovenular ratio; and increased vessel tortuosity density. Discriminative ability of the overall model to identify COPD had 90% sensitivity, 28% specificity, 12% positive predictive value and 96% negative predictive value with 0.67 area under curve. Conclusion Individuals with COPD show retinal evidence of neurodegeneration (thinner GCIPL and NFL) and microvascular dysfunction (increased vessel width mostly driven by venules), reflecting systemic vascular disease. However, these changes lack sufficient discriminative accuracy for use as a non-invasive diagnostic tool. This abstract is funded by: Republic of Türkiye Ministry of National Education “Postgraduate Study Abroad” scholarship programme

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