Simultaneous screening for liver fibrosis during retinal scanning shows promise as a novel pathway for detecting advanced liver disease in patients with type 2 diabetes (T2D).

Noting that false positives were potentially common on second visits, the authors wrote, "This risk must be considered if implementing this method into clinical routine."

"It is possible that only doing a VCTE in patients with an elevated [fibrosis-4] score, by increasing pretest probability of fibrosis, might lead to a higher positive predictive value than a single VCTE without confirmation," experts from the School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy, wrote in an accompanying editorial.

The study was led by Andrea Lindfors, MD, Division of Hepatology, Department of Upper Gastrointestinal Diseases, Karolinska University Hospital, Stockholm, Sweden. It was published online in The Lancet Gastroenterology & Hepatology.

There were large amounts of missing laboratory data from initial visits, primarily due to the absence of an on-site blood test facility. The COVID-19 pandemic may have influenced participants' willingness to engage with healthcare services. The use of different VCTE devices at different sites could have affected measurement values. Researchers did not verify the presence of advanced fibrosis through liver biopsy in participants with liver stiffness measurements exceeding 12.0 kPa at the second visit.

The study received funding from Gilead Sciences, Pfizer, Region Stockholm, and other sources. One author declared receiving research funding, serving as a consultant or on advisory boards, and having other ties with several pharmaceutical companies.