ARVO 2026: A non-invasive tool to study the eye-heart relationship

A one-lead electrocardiography (ECG) device synchronized with ocular Doppler holography may serve as a non-invasive assessment tool for studying the relationship between the eye and the heart. Keren Wood Shalem, MD, MPH, and colleagues describe their device and custom software in a poster presentation at the Association for Research in Vision and Ophthalmology (ARVO) 2026 annual meeting in Denver, Colorado, May 3–7.¹ Shalem is the first study author from the Icahn School of Medicine at Mount Sinai and New York Eye and Ear Infirmary of Mount Sinai, both in New York.

The investigators designed the one-lead ECG device and custom software to synchronize cardiac electrical activity with ocular Doppler holography. The study included 25 participants (50 eyes) that underwent imaging; each eye was imaged 5 times on the same day.

The investigators used the computer platform MATLAB to detect R-wave peaks from the ECG. They then extracted the peak systolic velocity (PSV), maximal upstroke slope (dV/dtmax) and the point at which the upstroke of the Doppler waveform reaches 50% of the PSV (T½) from the Doppler holography. They calculated the time from the R-wave peak to each holography metric (T_PSV, T_MaxSlope and T_T½). The beats within each acquisition were averaged, which were then used to calculate the between-image intraclass correlation coefficients (ICCs) and coefficients of variation (CVs).

Results from 50 eyes

The following measurements were obtained from the 50 eyes, expressed in seconds unless otherwise noted. The mean ± standard deviation PSV from all eyes was 27.078 ± 3.379 mm/s; T_PSV was 0.183 ± 0.026; T_MaxSlope was 0.129 ± 0.018; and T_T½ was 0.130 ± 0.019.

The authors reported that the ICCs ranged from moderate to good, with the highest found for T_T½ (ICC 0.782); lower ICC measurements were found for PSV (0.748) and T_MaxSlope (0.742), and the lowest for T_PSV (0.652).

The median CV values were low: 5.2% for PSV, 5.8% for T_PSV, 6.0% for T_MaxSlope and 4.8% for T_T½, indicating consistent measurements across repeated acquisitions.

Shalem and colleagues concluded that “ECG-synchronized Doppler holography produces repeatable cardiac cycle-resolved measurements of retinal blood flow with low variability between repeated acquisitions. Of the time-based metrics, T_T½ showed the highest repeatability, with the results suggesting that it may be the most reliable metric for quantifying the timing of the retinal blood flow with respect to the cardiac cycle. These findings indicate that this ECG-Doppler system may serve as a non-invasive assessment tool for further studying the eye-heart relationship.”

Reference

1. Shalem KW, Harris A, Muncharaz Duran L, et al. Electrocardiogram-synchronized Doppler holography system for quantifying cardiac cycle-resolved retinal blood flow. ARVO 2026 Annual Meeting; May 3–7, 2026; Denver, Colorado. Poster 0788.