Central Retinal Volume May Predict Mortality in Elderly Patients

Although all non-cardiovascular causes of death were linked to lower CRV in this population-based study, no relationship was identified between cardiovascular mortality or its risk factors and CRV, suggesting that a mechanism beyond cardiovascular disease must explain the association.  Photo: Chiku Y, et al. Ophthalmol Sci. July 16, 2025. Click image to enlarge.  Changes in the retina, as observed on OCT, can act as a window into overall health. A new study in Graefe's Archive for Clinical and Experimental Ophthalmology identified a link between the OCT-based measurement of central retinal volume (CRV) and non-cardiovascular mortality in a large population of older adults. Researchers propose that this automated biomarker, once validated, could function as a noninvasive tool for predicting mortality risk in geriatric patients.The study used a population-based cohort design within the AugUR initiative, encompassing 2,166 participants aged between 70 and 95 years. Central retinal volume (CRV) was measured on spectral-domain OCT using a Heidelberg Spectralis device. During the observation period (median: 5.9 years), 374 participants passed away, resulting in a mortality rate of 17.3%.The data indicated a significant association between CRV and all-cause mortality, revealing that a one standard deviation decrease in CRV corresponded to an increase in mortality risk, with a hazard ratio of 1.17 even after adjusting for confounding factors such as age, sex, body size, diabetes and hypertension. Those with CRV measurements below the median (8.40mm³) exhibited a notably higher mortality risk compared to their counterparts with higher volumes. While all causes of non-cardiovascular deaths were associated with lower CRV (hazard ratio: 1.25), there was no correlation found between cardiovascular mortality or its risk factors and CRV. The researchers note in their paper that this observation “points to a mechanism beyond CVD for the association of lower CRV with increased mortality risk in our study sample.” Another interesting finding from the study was that the association between CRV and morality was only “significant in those who had already exceeded their expected life expectancy (hazard ratio 1.21) but not in women below 83 years and men below 78 years, respectively.” Although this suggests CRV cannot predict premature mortality, the authors caution that it’s important to consider that the study sample was aged 70 or older, excluding premature deaths occurring before the eighth decade of life.In summary, the authors wrote, “Together with the observation that CVD and its risk factors did not substantially attenuate the association of all-cause, non-CVD and late mortality, our results indicate that CRV is a marker for mortality risk beyond the cardiovascular spectrum in our old-aged cohort.” They conclude, “If validated, CRV could serve as a simple and automated biomarker to assess mortality risk in the aging population and support risk stratification through non-invasive OCT screening in geriatrics.”Click here for the journal source. Stark KJ, Zimmermann ME, Helbig H. et al. Central retinal volume derived from optical coherence tomography as a potential predictor of mortality in the old-aged population–results from the German AugUR study. Graefes Arch Clin Exp Ophthalmol. August 5, 2025. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.