Compared with children of a healthy weight, those with obesity in this study had a lower vessel density despite a recent diagnosis within the last three years. Photo: Epic Health. Click image to enlarge.
The increasing prevalence of childhood obesity is a major health problem today due to its association with numerous forms of cardiovascular disease. Obesity also has been demonstrated to result in retinochoroidal microvascular changes, visible on OCT-A; however, these studies failed to consider obesity duration. To help close this gap in research, a recent study looked at a cohort of newly obese children and found that in most, retinochoroidal microvascular changes had already occurred.
The study included 40 children aged seven or eight who were diagnosed as obese within the previous three years, which was defined as having a BMI greater than or equal to the 95th percentile. Forty age- and sex-matched controls also participated. Each child underwent a comprehensive eye examination including axial length, cycloplegic refraction and OCT-A scans.
The researchers reported in their paper in BMC Ophthalmology that newly obese children “had lower vessel density in the inferior parafovea, nasal parafovea and temporal perifovea of the deep vascular complex (DVC), higher vessel density in the fovea of the superficial vascular complex and the fovea of the DVC and smaller foveal avascular zone when compared with controls.” On the other hand, they observed no differences in any quadrant of total retinal thickness, subfoveal choroidal thickness and choriocapillaris flow voids. Age, spherical equivalent refraction and axial length were also not different between newly obese children and controls.
Based on these findings, the researchers recommend early screening and frequent eye examinations for children with obesity, even if the diagnosis was more recent. They also noted in their paper that “retinal microvascular insult may precede its structural change and that the retina may be a better candidate to predict the onset of retinochoroidal microvascular changes than the choroid in the early stages of childhood obesity, which may help to characterize the underlying pathophysiology of obesity and enable early detection and prevention of obesity-related ocular complications.”
Han S, Leng, Z, Li X, et al. Retinochoroidal microvascular changes in newly developed obese children: an optical coherence tomography angiography study. BMC Ophthalmol. November 17, 2022. [Epub ahead of print].