Artificial Intelligence in Assessing Cardiovascular Diseases and Risk Factors via Retinal Fundus Images: A Review of the Last Decade

Background: Cardiovascular diseases (CVDs) continue to be the leading cause of mortality on a global scale. In recent years, the application of artificial intelligence (AI) techniques, particularly deep learning (DL), has gained considerable popularity for evaluating the various aspects of CVDs. Moreover, using fundus images and optical coherence tomography angiography (OCTA) to diagnose retinal diseases has been extensively studied. To better understand heart function and anticipate changes based on microvascular characteristics and function, researchers are currently exploring the integration of AI with non-invasive retinal scanning. Leveraging AI-assisted early detection and prediction of cardiovascular diseases on a large scale holds excellent potential to mitigate cardiovascular events and alleviate the economic burden on healthcare systems. Method: A comprehensive search was conducted across various databases, including PubMed, Medline, Google Scholar, Scopus, Web of Sciences, IEEE Xplore, and ACM Digital Library, using specific keywords related to cardiovascular diseases and artificial intelligence. Results: A total of 87 English-language publications, selected for relevance were included in the study, and additional references were considered. This study presents an overview of the current advancements and challenges in employing retinal imaging and artificial intelligence to identify cardiovascular disorders and provides insights for further exploration in this field. Conclusion: Researchers aim to develop precise disease prognosis patterns as the aging population and global CVD burden increase. AI and deep learning are transforming healthcare, offering the potential for single retinal image-based diagnosis of various CVDs, albeit with the need for accelerated adoption in healthcare systems.