Optos, a division of Nikon Co. Ltd, and Toku are collaborating to add Toku’s artificial intelligence (AI)-based BioAge solution to Optos’s ultra-widefield (UWF) imaging devices.
This agreement was announced ahead of the 2025 Vision Expo West (VEW) meeting in Las Vegas, Nevada, taking place Sept. 17-20.
First, a look at these companies.
We’ll start with Optos.
This retinal imaging company’s specialty is developing integrated UWF high-resolution digital images with image-guided optical coherence tomography (OCT).
Its imaging portfolio targets early detection, management, and treatment of ocular conditions.
What makes these devices unique: Is their ability to image over 80% (or 200°) of the retina in a single capture—a vast improvement from the standard 10 to 100° associated with traditional, small-field retinal imaging.
And Toku?
With U.S. headquarters in San Diego, California, Toku is a commercial medical device company that develops non-invasive, AI-controlled diagnostic and screening tools via retinal imaging.
Its patented technologies target three key therapeutic areas of focus: biological age, cardiovascular risk, and chronic kidney disease.
- To note: The company was previously granted FDA Breakthrough Device Designation for CLAiR, its technology platform designed to provide non-invasive cardiovascular disease evaluations via fundus retinal imaging.
So what’s this BioAge technology you mentioned earlier?
That would be an annual, non-invasive retinal scan designed to estimate a person’s individual biologic age by utilizing AI-based algorithms and analyzing biometric markers within the retina.
- The intent: To give an indication of their overall systemic health.
But keep in mind: The company emphasizes that BioAge is not a medical device—it’s intended to be used for “for maintaining or encouraging a healthy lifestyle and is unrelated to the diagnosis, cure, mitigation, prevention, or treatment of a disease or condition.”
- As for its regulatory status—it varies depending on the market and region.
Explain this AI component more.
Essentially, Toku’s AI algorithm is trained to know what to look for.
How: By first analyzing various fundus image examples—each with known outcomes—to learn the connection between specific patterns and results.
- Once trained, the AI is able to analyze new fundus images from a patient to generate insights based on that learning.
And how does the technology work in BioAge?
The platform uses a patented method to evaluate over 23 million technical parameters and 12 biological parameters in each captured retinal image to generate an accurate BioAge.
From just one fundus image, four key areas are identified:
- Blood vessels (indicating their cardiovascular health)
- Nerve (for insights into neurological health)
- Macula (to estimate their rate of aging and inflammatory health)
- Image clarity (to determine the rate of which their lens is aging)
I’m curious … any clinical research into the test?
There is, actually. See here for details on 2024 research supporting BioAge in identifying patients with underlying indicators of cardiovascular, kidney, and metabolic diseases.
Nice! Now to the test itself.
The three-step process involves:
- Acquiring fundus images from a patient as well as such data like their age, gender, and ethnicity
- Running the retinal images through Toku’s AI engine and deep learning technology to determine a patient’s BioAge
- Generating the BioAge results, including a patient’s biological age, health risk levels, and potential recommendations
- Take note: These results are formatted in a pdf for clinicians to review as well as accessible for patients via Toku’s online portal
As for the duration: The test itself takes just a few minutes (as an add-on to clinic visits), while a BioAge result is reportedly provided within 20 to 40 seconds of a clinician pressing the button.
Which age groups can this be used on?
Patients aged 35 to 75.
Importantly, however: The test isn’t currently intended for patients who are pregnant, have had a previous cardiac event, or who have persistent vision impairment, monocular vision, congenital eye disease, a history of significant ocular trauma, or pathological myopia.
Let's talk camera compatibility.
This is where the Optos partnership comes in. BioAge can now be used with both Topcon Healthcare and Optos devices.
- For Topcon: This includes the True Color Fundus (TRC)-NW400 and NW500 as well as the Maestro1 and Maestro2 OCT Camera.
And for Optos: The test is available to users of the following UWF retinal imaging devices:
- Daytona
- Monaco
- MonacoPro (an upgrade to the Monaco; see our coverage)
- California (coverage here)
So why integrate with Optos devices?
To target the reported +20,000 eyecare practices across the United States already utilizing Optos UWF imaging devices in their everyday clinical workflow.
For those eyecare providers, the two companies noted that adding BioAge enables them to “expand their health and wellness insights without the need to replace existing hardware.”
Last question: How can I learn more about this test?
If you’re attending VEW this week, see BioAge for yourself by stopping by the Optos booth #F9065.
Otherwise, reach out to the company to discuss availability and pricing for your practice.