Using the retina as a microcosm for gauging the health of the entire human body, from the eye to the heart—an approach known as oculomics—is proving more and more intriguing to physicians. No institution is working harder to advance the science and technology of oculomics and, ultimately, integrate it into clinical practice than New York Eye and Ear Infirmary of Mount Sinai (NYEE).
This has meant bringing a sophisticated Doppler holography imaging system to the United States from its European originator and using it to measure variations in the flow of blood into and out of the optic nerve to ferret out clues about a wide range of pathologies.
Richard B. Rosen, MD, FARVO, Vice Chair of Ophthalmic Research at NYEE, was among the first to recognize this approach’s enormous potential and formed an ongoing partnership with physicist and laser Doppler holography (LDH) developer Michael Atlan, PhD, at the Institut Langevin–Ondes et Images in Paris. Helping to propel the work is a grant from the New York Eye and Ear Infirmary Research Foundation.
Unlike optical coherence tomography angiography, which visualizes vascular architecture, LDH enables high-temporal-resolution assessment of dynamic blood-flow changes across the retinal circulation, creating opportunities to study vascular physiology in ways previously unavailable.
“The eye holds an advantage over almost every other human organ because it allows us to observe what’s happening elsewhere in the body without having to open someone up,” says Dr. Rosen. “And laser Doppler holography is the enabling vehicle for that—the way we can view the vasculature of the entire body—since, when people have reductions in elasticity within the walls of blood vessels, it tends to be reflected everywhere: in the heart, the kidneys, and the brain, as well as the eyes.”
The technology’s abilities are already evolving under Dr. Rosen and Alon Harris, MS, PhD, FARVO, Professor of Ophthalmology, and Artificial Intelligence and Human Health, and Interim Director of the Barry Family Center for Ophthalmic Artificial Intelligence and Human Health at the Icahn School of Medicine at Mount Sinai. Together they are developing novel methods for researchers at NYEE and Mount Sinai to explore how retinal blood flow—and eventually choroidal perfusion of the outer retina—can provide advance warning of glaucoma, age-related macular degeneration (AMD), thyroid eye disease, papilledema, and many others.
“The eye holds an advantage over almost every other human organ because it allows us to observe what’s happening elsewhere in the body without having to open someone up.”
- Richard B. Rosen, MD, FARVO
A Breakthrough: Synchronizing Eye and Heart Signals to Reveal Hidden Disease Risk
Among the earliest success stories to emerge from this groundbreaking work is a new study by Dr. Harris, which for the first time links LDH with a conventional electrocardiogram (ECG) to capture how blood flow to the retina responds to each heartbeat with millisecond precision.
The idea of synchronizing cardiac and retinal signals was developed by Dr. Harris and stems from earlier work where he linked color Doppler imaging of the eye’s retrobulbar blood vessels with ECG and echocardiogram data. Those efforts provide a novel way to measure perfusion deficits that are characteristic of ocular conditions like glaucoma and AMD, as well as systemic abnormalities that offer potential signs of heart disease, diabetes, sickle cell disease, and Alzheimer’s disease.
“We’re establishing a new measurement framework that connects cardiac activity directly to retinal microvasculature, opening the door to future studies that can explore how cardiac function and vascular health are reflected in real-time retinal blood flow,” says Dr. Harris, a Principal Investigator and lead author of the study, published in the May 2026 issue of Nature. “From this first-ever system, we will be able to build prediction models that could integrate AI with LDH and ECG to ensure the greatest possible accuracy and repeatability.”
Dr. Atlan developed the LDH system's ECG interface with a team of programmers who worked closely with Keren Wood, MD, and graduate student Luis Muncharaz Duran from the laboratories of Drs. Harris and Rosen. Dr. Wood and Alice Verticchio, MD, PhD, performed prospective study visits, and Yash Lahoti, MSE, and graduate student Nicholas Schnorbus helped develop the software. Beyond its technical achievement, the work reported in Nature advances the emerging platform of oculomics.
“We’re opening up a whole new era of oculomics, in which the eye and its blood supply can serve as a window into the body and allow us to look at a range of disorders beyond the eye, including cardiac disease and contractility of the heart, peripheral vascular disease, and even kidney function,” explains Dr. Harris, who has spent a good portion of his career examining how vascular and cardiovascular risk factors impact the development and progression of glaucoma, AMD, diabetes, and others. “The back of the eye is one of the most information-rich windows in medicine; the three important elements are ocular imaging, large data sets, and predictive screening models.”
Looking further down the road, Dr. Rosen, who is also the Belinda Bingham Pierce and Gerald G. Pierce, MD Distinguished Professor of Ophthalmology at the Icahn School of Medicine, envisions a time when technology coupling LDH with ECG could become as practical and standard as taking one’s blood pressure. In this scenario, retinal imaging could expand beyond the research lab into physicians’ offices, and even pharmacies and drug stores that have blood pressure machines.
“The ultimate goal is to use the LDH-ECG system, equipped with AI, to make people aware in advance of health problems,” says Dr. Rosen. “Instead of waiting for a disabling event like a stroke or heart attack to occur, they would be encouraged to proactively see a physician or specialist. That could potentially help change health care in this country.”