Subfoveal choroidal thickness and peripapillary retinal nerve fiber layer thickness in young obese males

Impaired brachial flow-mediated dilation may predict choroidal and retinal nerve fibre layer thickness changes in people with obesity

CLINICAL RELEVANCE

Choroidal thickness and peripapillary retinal nerve fibre layer (RNFL) changes are known to occur in obesity. Endothelial dysfunction and systemic atherosclerosis may play a role in the pathophysiology of these differences.

BACKGROUND

Flow-mediated dilation (FMD) is reduced in patients with endothelial dysfunction, and the ankle-brachial index is a surrogate marker for atherosclerosis. This study was conducted to examine the relationship between systemic vascular parameters (FMD, and ankle-brachial index), subfoveal choroidal thickness, and peripapillary RNFL thickness in obese individuals.

METHODS

This observational, cross-sectional study involved 108 total participants who were divided into two groups. One group consisted of 54 obese subjects who each had a body mass index of 30 kg/m2 or more. The other control group contained 54 participants who each had a body mass index of 25 kg/m2 or less but higher than 20 kg/m2 . For each participant, only one eye was examined in this study. Subfoveal choroidal thickness, RNFL thickness, ankle-brachial index, and ultrasound measurement of the brachial artery FMD were performed. FMD was categorised according to receiver operating characteristic analysis, and endothelial dysfunction was defined as an FMD ≤ 7.29%.

RESULTS

Subfoveal choroidal and RNFL thicknesses in the temporal quadrant were significantly lower in the obese group (p < 0.05). Lower mean values of subfoveal choroidal and RNFL thicknesses in the temporal and inferior quadrants were observed in subjects with an FMD ≤ 7.29% (p < 0.05). In people with obesity, FMD was positively correlated with subfoveal choroidal thickness (r = 0.322, p = 0.001), inferior RNFL thickness (r = 0.259, p = 0.007), and temporal RNFL thickness (r = 0.297, p = 0.002). However, the ankle-brachial index was not correlated with obesity.

CONCLUSIONS

Impaired FMD was associated with reduced subfoveal choroidal and RNFL thicknesses in the temporal and inferior quadrants of people with obesity.

Periodontitis Provokes Retinal Neurodegenerative Effects of Metabolic Syndrome: A Cross-Sectional Study

BACKGROUND

This cross-sectional study aims to investigate the retino-choroidal degenerative effects of periodontitis, metabolic syndrome (Mets), and the combination of these diseases using optical coherence tomography (OCT) measurements.

METHODS

Ninety-two patients selected according to inclusion criteria were divided into four groups: systemically and periodontally healthy (control), systemically healthy periodontitis (PD), periodontally healthy metabolic syndrome (MetS), and periodontitis and metabolic syndrome combined (PD-MetS). The systemic inflammatory-oxidative effects of periodontitis and MetS were biochemically evaluated using the serum TNF-α level, IL-1β/IL-10 ratio, and oxidative stress index (OSI: TOS/TAS). Retinal (AMT, pRNFLT, and GCL + T) and choroidal (SFCT) morphometric measurements and vascular evaluations (foveal capillary density) were performed via OCT Angio with swept-source technology.

RESULTS

Both periodontitis and Mets cause systemic inflammatory stress characterized by significant increases in the IL-1β/IL-10 ratio and OSI (p < 0.05). Compared to the control group, the AMT was significantly thinner in the MetS group, the pRNFLT was significantly thinner in the PD-MetS group, and the SFCT was significantly thinner in both groups (p < 0.05). The GCL+ was slightly thicker in the Mets groups. (p > 0.05) Foveal capillary density did not differ significantly among the groups. (p > 0.05).

CONCLUSIONS

Periodontitis-related inflammatory stress alone causes changes in retinal and subfoveal choroidal thicknesses that are not statistically significant. On the other hand, when combined with Mets, it may significantly provoke the retinal neurodegenerative effects of this disease.

Normative data for macular and retinal nerve fibre layer thickness in healthy German children and adolescents using optical coherence tomography

PURPOSE

To establish normative data for macular thickness, macular volume and peripapillary retinal nerve fibre layer (RNFL) thickness using Spectralis® spectral-domain optical coherence tomography (SD-OCT) in healthy German children and adolescents and investigate influencing factors.

METHODS

The cross-sectional study included the right eye of 695 children with at least one complete retinal OCT scan. As part of the LIFE Child study, the children underwent an ophthalmological examination including axial length (AL), spherical equivalent (SE) and OCT measurements. Various questionnaires were answered by the children or their parents to identify media use or outdoor time. Multiple linear regression models were used to investigate the potential influencing factors.

RESULTS

A total of 342 boys and 353 girls with an average age (SD) of 12.91 (3.29) years participated. The mean AL (SD) was 23.20 (0.86) mm. The mean macular thickness (SD) was 320.53 (12.29) μm and the mean RNFL thickness (SD) was 102.88 (8.79) μm. Statistical analysis revealed a significant correlation between average macular thickness and age (p < 0.001, β = 0.77) as well as AL (p < 0.001, β = -4.06). In addition, boys had thicker maculae (p < 0.001, β = 5.36). The RNFL thickness showed no significant correlation with children's age (p > 0.05), but with AL (p = 0.002, β = -2.15), birth weight (p = 0.02, β = 0.003) and a gender-specific effect of the body mass index standard deviation score for male participants (p = 0.02, β = 1.93).

CONCLUSION

This study provides normative data and correlations between macular and RNFL thickness in healthy German children. Especially age, gender and AL must be taken into account when evaluating quantitative OCT measurements to classify them as normal.

Effect of bariatric surgery on macular and peripapillary choroidal structures in young patients with morbid obesity

OBJECTIVE

To examine the effect of bariatric surgery on the macular and peripapillary choroid in the late postoperative period in young patients with morbid obesity and compare them with a healthy control group.

METHODS

This prospective controlled study included 50 eyes of 25 young patients with morbid obesity and 50 eyes of 25 age and sex-matched healthy controls. Sleeve gastrectomy was performed on all patients with obesity. Preoperative and 6-month postoperative macular and peripapillary choroidal thickness, total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were performed. Results were compared with healthy controls by using enhanced depth imaging optical coherence tomography.

RESULTS

Choroidal thickness and CVI values were smaller in patients with obesity in both macular and peripapillary areas compared with the healthy control group (both p < 0.001). There was a statistically significant increase in the macular and peripapillary choroidal thickness of patients with obesity when the preoperative and the postoperative 6-month values after bariatric surgery were compared (both p < 0.001). Also, it was found that bariatric surgery increased TCA and LA values in the macular and all sectors of peripapillary areas (all p < 0.001), and CVI values in the temporal and nasal peripapillary sectors (p = 0.007, p = 0.012, respectively).

CONCLUSIONS

Bariatric surgery was found to increase the macular and peripapillary choroidal thickness and the nasal and temporal peripapillary CVI values in young patients with morbid obesity in the late period. To the best of our knowledge, the current study has shown for the first time that bariatric surgery affects peripapillary choroid and CVI values.

Effect of Obesity on Retinal Integrity in African Americans and Caucasian Americans With Relapsing Multiple Sclerosis

Objective: To study the effect of obesity on retinal structures in African Americans (AAs) and Caucasian Americans (CAs) with relapsing-remitting multiple sclerosis (RRMS).

Methodology: About 136 patients with RRMS without history of optic neuritis were divided into two groups, based on body mass index (BMI): 67 obese (40 AA, 27 CA, mean BMI ± SD: 36.7 ± 5.8), and 69 non-obese (23 AA, 46 CA, mean BMI ± SD: 24.0 ± 3.1). The peripapillary retinal nerve fiber layer (pRNFL) thickness was quantified by optical coherence tomography (OCT) and was segmented into quadrant thickness: superior (S), inferior (I), temporal (T), and nasal (N). Papillomacular bundle (PMB) thickness, retinal nerve fiber layer (RNFL), ganglion cell + inner plexiform layer (GCIPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), and total macular (TMV) volumes were obtained.

Results: Obesity was associated with lower T thickness (58.54 ± 15.2 vs. 61.9 12.4, p = 0.044), higher INL (0.98 ± 0.07 vs. 0.96 ± 0.06, p = 0.034), and lower RNFL (0.77 ± 0.14 vs. 0.82 ± 0.12, p = 0.009) volumes. Obese AA had significantly thinner T (58.54 ± 15.19 vs. 61.91 ± 12.39, p = 0.033), N (68.94 ± 2.7 vs. 77.94 ± 3.3, p = 0.044), and TMV (8.15 ± 0.07 vs. 8.52 ± 0.09, p = 0.003), RNFL (0.74 ± 0.02 vs. 0.82 ± 0.02, p = 0.013), OPL (0.76 ± 0.01 vs. 0.79 ± 0.1, p = 0.050), ONL (1.68 ± 0.031 vs. 1.79 ± 0.038, p = 0.026), and GCIPL (1.78 ± 0.04 vs. 1.9 ± 0.05, p = 0.038) compared to obese CA. Among patients with non-obesity, the ONL was significantly lower in AA (1.78 ± 0.04 vs. 1.9 ± 0.05, p < 0.001).

Conclusions: Obesity is associated with retinal structure abnormalities in patients with RRMS. Its impact might be more prominent in AA than CA. Large longitudinal studies are needed to validate our findings.