Ai-driven oculomics: Retinal imaging biomarkers for systemic disease - from cardiovascular risk to neurodegeneration and foundation models

Introduction and aim: The retina offers a unique, non-invasive window into systemic vascular and neurological health. Deep-learning algorithms applied to retinal photographs and optical coherence tomography (OCT) can predict cardiovascular events, detect chronic kidney disease, estimate biological age, and identify neurodegenerative diseases - a field termed oculomics. This review synthesizes current evidence on AI-driven oculomics across cardiovascular, cardio-renal-metabolic, neurodegenerative, and aging domains.