Eyes on Health: Leveraging Oculomics for Systemic Disease Insights in the All of Us Research Program

As precision medicine initiatives continue to expand, imaging is playing a larger role in uncovering biomarkers that extend far beyond a single specialty. The Eyes on Health Partnered Research Study is a national collaboration between the All of Us Research Program, National Eye Institute, and National Institute of Biomedical Imaging and Bioengineering designed to explore how high-resolution retinal imaging can reveal indicators of cardiovascular, metabolic, and neurologic disease. By collecting multimodal ophthalmic images from 5,000 diverse participants, this initiative offers a real-world example of how oculomics can support broader systemic health research. 

This session will examine the operational and informatics framework required to design and implement a population-scale imaging study within a national research cohort. Attendees will gain practical insight into imaging workflow development, including standardized acquisition of color fundus photography, optical coherence tomography (OCT), and OCT angiography, as well as the challenges of harmonizing metadata, managing image quality, and supporting multi-site interoperability. Presenters will also discuss the integration of ophthalmic imaging into the secure All of Us Researcher Workbench, enabling linkage with genomic, clinical, and social determinants of health data for precision medicine discovery. 

Beyond the technical infrastructure, attendees will explore how retinal imaging biomarkers are being leveraged to identify early signals of hypertension, diabetic complications, cardiovascular risk, and neurodegenerative disease. The session will also address participant-centered return-of-value strategies, governance considerations when clinically significant findings are detected, and lessons learned from building scalable infrastructure for future multimodal imaging research initiatives. Participants will leave with a practical roadmap for applying these informatics principles to other enterprise and population-based imaging studies. 

Objectives

• Describe the imaging acquisition workflow and operational components required to support a national oculomics research study  
• Differentiate key informatics challenges related to ophthalmic image standardization, metadata harmonization, and multi-site interoperability  
• Explain how multimodal imaging data can be integrated with clinical, genomic, and social determinant datasets to enable precision medicine research  
• Identify scalable governance and participant-engagement strategies for population-based imaging initiatives