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World J Hypertens. Sep 26, 2026; 12(1): 124669
Published online Sep 26, 2026. doi: 10.5494/wjh.124669
Published online Sep 26, 2026. doi: 10.5494/wjh.124669
Retina as a window to systemic hypertension: From hypertensive retinopathy to artificial intelligence-driven microvascular biomarkers
Yehya Tlaiss, Serena Akiki, Naynawa Moussawi, Reine Zeidan, Abbas Zghaib, Issam Fassih, Department of Ophthalmology, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Author contributions: Tlaiss Y conceived and designed the review, developed and executed the literature search strategy, performed evidence synthesis and wrote the manuscript; Akiki S and Moussawi N performed title, abstract and full-text screening and data extraction, and constructed the evidence tables; Zeidan R and Zghaib A performed the supplementary hand-search of reference lists, verified all extracted quantitative data against the primary sources and prepared the figures; Fassih I supervised the project, arbitrated screening disagreements and critically revised the manuscript for important intellectual content; and all authors have read and approved the final version of the manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest relevant to this manuscript.
Corresponding author: Yehya Tlaiss, MD, Department of Ophthalmology, University of Bala
Received: June 23, 2026
Revised: July 25, 2026
Accepted: September 18, 2026
Published online: September 26, 2026
Processing time: 93 Days and 9.2 Hours
Revised: July 25, 2026
Accepted: September 18, 2026
Published online: September 26, 2026
Processing time: 93 Days and 9.2 Hours
Core Tip
Core Tip: The retina offers a directly visualisable model of the systemic microcirculation, and the integration of quantitative vascular metrics with deep-learning analysis of fundus images now allows blood pressure and cardiovascular risk to be inferred non-invasively at population scale. Realising this potential requires standardisation of measurement, validation across ethnicities and prospective demonstration that retina-derived biomarkers improve clinical decisions beyond esta