ABSTRACT:
Retinal imaging traditionally detects ocular conditions such as diabetic retinopathy, hypertension and glaucoma.1 However, increasing evidence shows that retinal images also provide insights into systemic vascular and metabolic health, relevant to diabetes, hypertension, cardiovascular disease, neurodegenerative disease, and HIV. 2,3 Advances in artificial intelligence (AI) and image analysis have significantly broadened the scope of retinal imaging. These technologies now enable automated interpretation and risk prediction of systemic diseases, fostering the development of oculomics.4,5 Additionally, this imaging modality can support remote diagnosis in rural healthcare facilities lacking specialized medical professionals. Despite this promise, the application of retinal imaging beyond eye care remains fragmented, particularly in low- and middle-income countries. Challenges include limited African datasets and normative data for the various imaging modalities, uncertainty about predictive retinal markers for systemic diseases, unclear clinical pathways following detection, and unresolved ethical and governance issues.6 Consequently, retinal imaging has not been fully leveraged as a public health asset for prevention, risk stratification, early detection, and surveillance. This organised session will explore the role of retinal imaging within public health systems, drawing on discussions from a recent multidisciplinary retinal imaging workshop in South Africa. The session will begin with a presentation outlining the increasing relevance of retinal imaging to public health, followed by a moderated panel discussion that will examine how multimodal retinal imaging can contribute to the earlier detection and prevention of non-communicable diseases, what this means for health systems, workforce training, and equity, how ethical and governance issues should be addressed as AI-enabled analysis becomes widespread, and retinal imaging’s role in strengthening population-level surveillance and planning. The session aims to stimulate cross-sector dialogue and identify practical next steps for advancing retinal imaging as a tool for public health impact, particularly in Africa and other resource-constrained settings.