Does Obesity Affect the Ocular Choroid Tissue in Children and Adolescents?

Abstract

Aim: Obesity may cause microangiopathic changes associated with the inflammatory process. The choroid tissue of the eye is one of the most highly vascularized tissues of body and supplies the outer 1/3 of the retina. Thinning in choroid tissue is an indicator of damage. Few studies have investigated obesity-induced choroid tissue damage in children, and their findings are inconsistent. The purpose of this study was to investigate changes in choroid tissue thickness in non-diabetic children and adolescents using optic coherence tomography (OCT) and the association with metabolic risk factors. Materials and Methods: One hundred fifty-six eyes of 38 obese and 40 healthy children and adolescents aged 10-18 were included in the study. The bilateral choroidal thicknesses were measured. We then investigated correlations between choroidal thickness and age, body measurements, pubertal stages, systolic and diastolic blood pressures, homeostasis model assessment insulin resistance and lipid values. Results: Mean choroidal thicknesses measured using OCT were 284.4±34.9 µm in the obese group and 316.3±39.7 µm in the control group (p=0.018). Choroidal thickness in the obese group decreased as body mass index (BMI) standard deviation scores (SDS) increased (r=-0.390, p=0.000). Conclusion: Mean choroidal thickness was lower in obese children and adolescents in this study compared to the healthy controls and thinning in the choroid tissue was more pronounced as BMI-SDS values increased. Increased adipose tissue may result in a susceptibility to damage by thinning choroid tissue.

Is there any connection between choroidal thickness and obesity?

“…A number of studies have consistently reported a negative association between SFCT and BMI measurements. 14 , 25 , 54 , 76 – 78 In a prospective study on obese children aged 5–15 years, Ers¸an et al 54 found a significant reduction in subfoveal and parafoveal choroidal thickness. They recorded baseline blood pressure and performed blood tests (serum insulin, plasma glucose, and lipids) after overnight fasting to control parameters that may affect choroidal thickness.…”

“…In normal populations, choroidal thickness differs topographically across the choroidal tissue and decreases from the fovea to the outer locations. 61 , 78 Furthermore, it has been shown that the superior and temporal areas of the choroid are the thickest quadrants, and the nasal area is significantly the thinnest quadrant across the horizontal choroidal scans. 91 , 92 In line with the findings of normal subjects, previous studies on the obese population indicated that choroidal thickness significantly reduced toward nasal regions.…”

“…These findings show that topographical variations across the choroid of obese people are similar to normal-weight people. 76 , 78 …”

“…These findings show that topographical variations across the choroid of obese people are similar to normal-weight people. 76,78 The association between obesity and choroidal thickness might be attributed to the development of obesity comorbidities such as diabetes mellitus, hypertension, dyslipidemia, cardiovascular diseases, stroke, and ischemia. 7,8,21,22,84 It is hypothesized that microvascular changes secondary to obesity in these associate diseases may contribute to choroidal thickness changes with the same mechanisms in obese patients.…”