An Assessment of Retinal Nerve Fiber Layer Thickness in Non-Diabetic Obese Children and Adolescents

Abstract

Objective:Obesity affects almost all systems in the body. This includes the retinal nerve fibers which may be damaged due to a chronic inflammatory process. To determine changes in retinal nerve fiber layer (RNFL) thickness in non-diabetic children and adolescents using optical coherence tomography (OCT) and to evaluate the relationship between this change, metabolic risk factors and pubertal stage.Methods:Thirty-eight obese and 40 healthy children and adolescents aged 10-18 years were included in the study. RNFL measurements from the optic disk and all surrounding quadrants were obtained using OCT from both eyes of the individuals in the study groups. Correlations between RNFL thickness and age, auxological measurements, pubertal stage, systolic and diastolic blood pressure, homeostasis model assessment-insulin resistance (HOMA-IR) index and lipid values were investigated.Results:A general decrease was observed in RNFL thickness in obese subjects compared to the controls, the decrease being highest in the inferior quadrant, although these differences were not statistically significant (p>0.05). RNFL thickness was negatively correlated with body mass index (BMI) standard deviation score (SDS) in both groups (control group r=-0.345, p=0.029; obese group r=-0.355, p=0.022). Significant negative correlations were determined between diastolic blood pressure, HOMA-IR, low density lipoprotein cholesterol level and RNFL thickness (r=-0.366, p=0.024; r=-0.394, p=0.016; and r=-0.374, p=0.022, respectively) in the obese group, while there was no association between these parameters and RNFL thickness in the control group.Conclusion:In this cross-sectional study, no statistically significant difference in RNFL thicknesses between the obese and control groups was determined. However, RNFL thickness was found to decrease in both healthy and obese children as BMI-SDS values increased. Further prospective studies may be of benefit to determine whether the decrease in RNFL values might become more pronounced on long-term follow-up.

Relationship between anthropometric and biochemical changes of metabolic syndrome with retinal nerve fiber layer and macular thickness

“…Laiginhas et al observed reduced thickness in the nasal and temporal sectors of the RNFL in their cohort of obese patients, after adjusting for confounders like hypertension, dyslipidemia, and diabetes [ 9 ]. Özen et al also observed a general decrease in RNFL thickness in non-diabetic obese children and adolescents (10–18 years old), which were more reduced in the inferior quadrant, similar to our findings in our cohort of adult patients [ 20 ]. Jung et al in their population based prospective study reported that patients who are metabolically healthy and obese are at higher risk of developing POAG compared to metabolically healthy and non-obese patients, suggesting that obesity carries some risk for POAG [ 11 ].…”

Macular Variability in Children and Adolescents with Metabolic Syndrome: A Cross-sectional Study Examining the Associations with Anthropometric Measurements, Metabolic Parameters and Inflammatory Markers

“…This chronic inflammation also has the potential to produce changes in the retina and macular layer (20). Indeed, previous MetS: metabolic syndrome studies have shown that obesity reduces the thickness of the retinal nerve fiber layer in children and affects choroid tissue (21,22,23). Some studies have shown that obesity leads to changes in the macular layers in children.…”

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

“…The RNFL and the thickness of choroid tissue can be affected by obesity. Previous studies have shown that obesity causes a thinning in RNFL thickness in children (23,24). Low level systemic inflammation is known to occur in obesity (25)(26)(27).…”