The assessment of peripapillary retinal nerve fiber layer and macular ganglion cell layer changes in obese children: a cross-sectional study using optical coherence tomography

Kartı, Ömer; Nalbantoğlu, Özlem; Abali, Saygın; Tunç, Selma; Özkan, Berna

doi:10.1007/s10792-016-0371-8

Cited by 28 publications

(48 citation statements)

References 45 publications

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“…The much older mean age (70.6 years) of the above study population than ours (48.6 years) might produce the difference. In the present study, BMI had a potentially positive influence on the thickness of inner retinal layers and OPL, while in the previous studies (34,35), BMI does not affect the thickness of the macular neuroretinal layers. We did not have plausible explanation for the difference.…”

Section: Discussioncontrasting

confidence: 72%

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Ishibashi

Tavakoli

2020

Front. Endocrinol.

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Aims: To investigate the impact of thinning at individual grids of macular neuroretinal layers, clinical factors, and inadequate light exposure on the specific components of sleep disorder in patients with type 2 diabetes.Methods: One hundred twenty-four patients with type 2 diabetes without clinical evidences of diabetic retinopathy and neuropathy (HbA1c: 8.3%, diabetes duration; 8.7 years) and 54 age-and sex-matched control subjects (HbA1c: 5.6%) underwent detailed clinical, neurological, and ophthalmological examinations. The sleep disorder was assessed by the Pittsburgh Sleep Quality Index Japanese Version (PSQI-J). The temporal structures of daily life were assessed by the Munich Chronotype Questionnaire Japanese Version. The thickness at nine grids defined by the Early Treatment Diabetic Retinopathy Study of nine macular neuroretinal layers was determined by swept-source optical coherence tomography and OCT-Explorer. The associations between the individual components of sleep disorders and the thickness at each grid of macular neuroretinal layers, clinical factors, or the temporal structures of daily life were examined.Results: The prevalence of the sleep disorder, global score, and four individual PSQI-J scores in patients with type 2 diabetes were higher than control subjects. The thickness of two and five grids of two inner retinal layers and four to seven grids of four outer retinal layers in patients with type 2 diabetes was thinner than those in control subjects. The thickness at one to eight grids of four outer retinal layers in type 2 diabetic patients was inversely associated with global score and five individual scores of sleep disorder. The thinning at one to two grids of the inner plexiform layer was related to three high individual scores of sleep disorder. The inappropriate light exposure was associated with the sleep disorder and altered macular neuroretinal layers. The high HbA1c and LDL-cholesterol levels were related to the high global score and two individual scores of sleep disorder, respectively. Ishibashi and Tavakoli Neuroretinal Alterations and Sleep DisorderConclusion: In patients with type 2 diabetes, the thinning at grids of the inner plexiform layer and outer retinal layers was associated with the high scores of specific components of the sleep disorder. The sleep disorder was also related to hyperglycemia, dyslipidemia, and inappropriate light exposure. Keywords: inappropriate light exposure, optical coherence tomography, Pittsburgh sleep quality index Japanese version, sleep disorder, thinning of macular neuroretinal layer, type 2 diabetes Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; GCL, ganglion cell layer; INL, inner nuclear layer; IPL, inner plexiform layer; IS/OS, junction of inner and outer segment of photoreceptor; OCT, optical coherence tomography; ONL, outer nuclear layer; OPL, outer plexiform layer; OPR, outer segment of photoreceptor/retinal pigment epithelium complex; PSQI-J, Pittsburgh Sleep Quality Index Japanese Version; RNFL, retinal nerve f...

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Section: Discussioncontrasting

confidence: 72%

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Ishibashi

Tavakoli

2020

Front. Endocrinol.

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“…Some studies have shown that obesity leads to changes in the macular layers in children. Although the methods and macular layers investigated differ in all these studies, it may nevertheless be concluded that obesity results in macular variability and damage in the pediatric age group (24,25,26). One animal study involving a rodent MetS and impaired glucose tolerance model demonstrated developmental retinal degeneration using microscopy and immunohistochemical methods (27).…”

Section: Discussionmentioning

confidence: 99%

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

Öztürk¹,

Özen²,

Çatlı³

et al. 2020

Jcrpe

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Macular damage may be observed in obesity and metabolic syndrome (MetS), a condition which leads to chronic subclinical inflammation and affects most organ systems. To investigate the association between macular variability and anthropometric measurements, metabolic parameters, and inflammatory markers in children and adolescents with MetS. Methods: Two hundred and twenty eyes of 62 obese and 48 healthy children and adolescents were examined. Bilateral macular retinal thickness (MRT) and macular retinal volume (MRV) were measured in all subjects using optical coherence tomography. Associations between mean MRT and mean MRV and age, auxological measurements including body mass index standard deviation scores (BMI-SDS) and waist circumference-SDS (WC-SDS), metabolic parameters and inflammatory parameters including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio and systemic immune-inflammatory index (SIII) were investigated. Results: No statistically significant difference was observed between the groups in terms of age or sex distribution (p>0.05). Mean MRT (r=-0.326, p=0.007) and MRV (r=-0.303, p=0.007) values in the obese group with MetS decreased as homeostasis model assessmentinsulin resistance (HOMA-IR) values increased. SIII values were higher in obese groups, but particularly in obese subject with MetS, compared to the control group (p=0.021). The decrease in mean MRT (r=-0.544, p=0.046) and MRV (r=-0.651, p=0.031) in the obese subjects with MetS was negatively correlated with NLR. Mean MRT and MRV decreased in all obese subjects as SIII increased (p<0.05). Conclusion: This is the first study to show that mean MRT and MRV values decrease as BMI-SDS, WC-SDS and HOMA-IR increase in obese children and adolescents with MetS. NLR and SIII may serve as markers of chronic inflammation in obese children with MetS associated with macular damage.

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“…Elía et al ( 20 ) found no relationship between BMI and RNFL thickness measured using OCT in healthy children. Karti et al ( 21 ) investigated 55 obese and 33 healthy children and reported a negative correlation between BMI-SDS and RNFL values. The presence of a refraction defect can cause inaccurate measurement of OCT and RNFL values ( 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

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

Özen¹,

Öztürk²,

Çatlı³

et al. 2018

Jcrpe

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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.

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The assessment of peripapillary retinal nerve fiber layer and macular ganglion cell layer changes in obese children: a cross-sectional study using optical coherence tomography

Abstract: Thinning in RNFL was detected in normal-looking discs of obese children, and this thinning negatively correlated with BMI SDS. Further studies including large series are needed to clarify whether obesity has an effect on RNFL thickness.

Cited by 28 publications

References 45 publications

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

Thinning of Macular Neuroretinal Layers Contributes to Sleep Disorder in Patients With Type 2 Diabetes Without Clinical Evidences of Neuropathy and Retinopathy

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

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

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