Evaluation of the impact of childhood obesity on retrobulbar hemodynamics and retinal microvasculature

Abstract

Objective To evaluate changes in retrobulbar ocular blood flow parameters by using Colour Doppler Imaging (CDI) and changes in foveal microvasculature by using Optical Coherence Tomography Angiography (OCTA) in pediatric obese patients and to compare them with a group of healthy children. Methods Children diagnosed with obesity without hypertension and diabetes (39 subjects, obese group) and age-matched healthy controls (26 subjects, control group) underwent CDI and OCTA imaging. Peak systolic velocity, end-diastolic velocity and resistivity index from ophthalmic, central retinal and posterior ciliary arteries on CDI; superficial and deep capillary plexus vascular density and foveal avascular zone area on OCTA imaging were obtained in each group. Central foveal and subfoveal choroidal thicknesses were also measured. CDI and OCTA parameters were compared between two groups. Results Peak systolic and end-diastolic velocities were found to be significantly lower in obese children than in controls in all three examined arteries (p < 0.05). Resistivity index values were similar between the groups. OCTA imaging did not reveal significant changes in superficial and deep capillary plexus vascular densities and foveal avascular zone area across analysed retinal regions between the groups. Subfoveal choroid was thicker in obese group than in control group (325.89 ± 52.77 µm vs. 304.52 ± 21.76 µm, p = 0.04). Conclusion An apparent decrease was present in retrobulbar hemodynamics in obese children. This arises the possibility of early ocular macrovascular compromise rather than retinal microvascular impairment in childhood obesity.

Measurement of Retrobulbar Blood Flow and Vascular Reactivity—Relevance for Ocular and Cardiovascular Diseases

“…Changes in retrobulbar blood flow related to obesity during childhood have also been detected by CDI. PSV and EDV of the OA, CRA and SPCA were significantly lower in obese children compared to controls while OCTA imaging did not show retinal microvascular impairment [111]. Lower PSV and EDV values in the CRA and OA in adult patients with obesity were also detected by CDI.…”

Retinochoroidal microvascular changes in newly developed obese children: an optical coherence tomography angiography study

“…Celik et al found an increase in subfoveal choroidal thickness in obese children. [ 10 ] Younger newly developed obese children in our study may be a reason for it. Obesity is chronic and progressive [ 11 , 12 ], believed to start many years before manifested microvascular dysfunction occurs.…”

“…Studies have reported that childhood obesity was associated with retinochoroidal microvascular changes using optical coherence tomography angiography (OCTA) [8][9][10]. However, it is unclear whether estimated associations are mainly driven by persons with long-standing obesity, persons with recently developed obesity, or some combination of both.…”

Obesity-induced ocular changes in children and adolescents: A review

“…Still, differences in OCTA values between obese and healthy children were not demonstrated by all authors ( 57 ), emphasizing the need for further research.…”

“…However, it must be emphasized that some studies have not found a significant difference between choroidal and retinal thickness in obese children compared to healthy controls (37,40,57). Further studies to verify changes in CT and MRT are needed in obese juvenile populations.…”