Evaluating the Effect of Childhood Obesity on Choroidal Structures

Abstract

Aim: To evaluate the effect of childhood obesity on choroidal structures with spectral-domain optical coherence tomography (SD-OCT). Material and Methods: A total of 80 children (20 children per each group; healthy, overweight, obese, and morbid-obese) were included in the study. Accompanying comorbidities such as insulin resistance, dyslipidemia, and metabolic syndrome were recorded. The subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) measurements were obtained from SD-OCT images and compared between groups. Results: No notable differences were found between groups regarding the means of age and axial length (p=0.504, and p=0.805, respectively). The SFCT medians (min-max) of healthy, overweight, obese, and morbid-obese children were 398.5 (319.0-453.5) μm, 299.0 (274.7-387.0) μm, 295.5 (257.0-385.0) μm, and 304.5 (272.2-386.0) μm respectively. Overweight and obese children had thinner choroid than non-obese healthy children (p=0.032). Besides, no significant correlation was observed between the severity of obesity and SFCT (p=0.722). In terms of CVI, total choroidal area, luminal area, and stromal area; no significant differences were found between groups (p=0.710, p=0.452, p=0.221, and p=0.863, respectively). Obese children with dyslipidemia had thinner SFCT than those not have dyslipidemia (292.0 (166-431)μm vs 348.0(173-491)μm, p=0.003), while insulin resistance and metabolic syndrome had no effect on SFCT (p=0.336, and p=0.211, respectively). Conclusion: Childhood obesity and accompanying dyslipidemia led to a decrease in SFCT without any significant change in the CVI. However, the severity of obesity and having insulin resistance or metabolic syndrome had no effect on either SFCT or CVI. The thinning in the SFCT may be related to microvascular disorders due to childhood obesity and dyslipidemia