The Retina as a Convergence Sentinel for Cross-System Signal Architecture

Retinal imaging predicts cardiovascular, neurological, metabolic, and psychiatric pathology with clinically meaningful effect sizes and lead times of three to seven years — yet these findings remain siloed by discipline. This preprint argues that the retina functions as a convergence sentinel: the only non-invasively accessible tissue where immune, vascular, neural, and metabolic cascades leave simultaneous downstream traces.

We outline the biological basis for this convergence, synthesize two decades of cross-domain evidence, and propose a prospective multi-omic cohort study architecture to test whether convergence-based interpretation improves clinical decision-making and patient outcomes beyond current single-domain approaches.

Portable retinal imaging is already deployed at scale for diabetic retinopathy screening and maternal health in resource-limited settings. This convergence framework opens pathways for integrated diagnostics, scalable early detection, and global health equity.