Fazla Kilolu Olmak Çocuklarda Koroidi Nasıl Etkiler?

Öz

Amaç: Bu çalışma kilo fazlalığının çocuklarda koroid kalınlığı (KT) ve koroid vasküler indeksini (KVİ) üzerine etkisini karşılaştırmayı amaçlamıştır. Materyal ve Metot: Çalışmaya 44 fazla kilolu ve obez çocuk ile 35 normal kilolu çocuk dahil edildi. Katılımcıların tam oftalmolojik muayenesinin ardından optik koherens tomografi ile makula ve koroid görüntüleri alındı. Foveanın merkezi makula kalınlığı, subfoveal, 1000 µm nazal ve 1000 µm temporal KT ölçüldü. Toplam koroid alanı (TKA), luminal alanı (LA) ve stromal alan (SA), ikilileştirme yöntemi kullanılarak ölçüldü. Bulgular: Aşırı kilolu grubun ortalama vücut kitle indeksi (VKİ) değeri 27,70±1.55; obez grubun ortalama VKİ değeri 35,73±3,84; kontrol grubunun ortalama VKİ değeri ise 21,56±1,44 idi. Subfoveal KT, TKA ve SA değerleri gruplar arasında anlamlı farklılık gösterdi (sırasıyla p=0,019, p=0,016, p=0,028). BMI ile subfoveal KT, TKA ve SA arasında anlamlı pozitif bir korelasyon mevcuttu (sırasıyla r=0,264, p=0,019; r=0,233, p=0,038; r=0,231, p=0,041). Sonuç: Obez grubun subfoveal KT, TKA ve SA değerlerinin kontrol grubuna göre anlamlı derecede yüksek olduğunu gösterdi. Ayrıca VKİ ile subfoveal KT, TKA ve SA arasında anlamlı pozitif korelasyon bulundu.

Anahtar Kelimeler

• Aşırı kilo
• koroid kalınlığı
• koroid vaskülarite indeksi
• optik kohorens tomografi
• pediatrik obezite

How does being Overweight Affect the Choroid in Children?

Abstract

Objective: The study aimed to compare the effect of overweight on choroidal thickness (CT) and choroidal vascular index (CVI) in children. Materials and Methods: This study included forty-four overweight and obese children and 35 children with normal weight. After a complete ophthalmological examination of the participants, macula and choroidal images were taken with optical coherence tomography. The fovea’s central macular thickness, subfoveal, 1000-µm nasal, and 1000-µm temporal CT were measured. Total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured using the binarization method. Results: The mean body mass index (BMI) value of the overweight group was 27.70±1.55. The obese group was 35.73±3.84, and the control group was 21.56±1.44. Subfoveal CT, TCA, and SA values significantly differed between the groups (p=0.019, p=0.016, p=0.028, respectively). A significant positive correlation existed between BMI and subfoveal CT, TCA, and SA (r=0.264, p=0.019; r=0.233, p=0.038; r=0.231, p=0.041, respectively). Conclusions: The obese group had significantly higher subfoveal CT, TCA, and SA values than the control group, and a significant positive correlation was found between BMI and subfoveal CT, TCA, and SA.

Keywords

• Choroidal thickness
• choroidal vascularity index
• optical coherence tomography
• overweight
• pediatric obesity

References

1. Faienza MF, Chiarito M, Molina-Molina E, et al. Childhood obesity, cardiovascular and liver health: a growing epidemic with age. World J Pediatr. 2020;16(5):438-445.
2. Tan AG, Kifley A, Flood VM, et al. Evaluating the associations between obesity and age-related cataract: a Mendelian randomization study. Am J Clin Nutr. 2019;110(4):969-976.
3. Jung Y, Han K, Park HYL, Lee SH, Park CK. Metabolic health, obesity, and the risk of developing open-angle glaucoma: Metabolically healthy obese patients versus metabolically unhealthy but normal weight patients. Diabetes Metab J. 2020;44(3):414-425.
4. Ng Yin Ling C, Lim SC, Jonas JB, Sabanayagam C. Obesity and risk of age-related eye diseases: a systematic review of prospective population-based studies. Int J Obes (Lond). 2021;45(9):1863-1885.
5. Čolak E, Pap D. The role of oxidative stress in the development of obesity and obesity-related metabolic disorders. J Med Biochem. 2021;26;40(1):1-9.
6. Ferrara M, Lugano G, Sandinha MT, Kearns VR, Geraghty B, Steel DHW. Biomechanical properties of retina and choroid: a comprehensive review of techniques and translational relevance. Eye (Lond). 2021;35(7):1818-1832.
7. Spaide RF. Choroidal blood flow: Review and potential explanation for the choroidal venous anatomy including the Vortex Vein System. Retina. 2020;40(10):1851-1864.
8. Steiner M, Esteban-Ortega MDM, Muñoz-Fernández S. Choroidal and retinal thickness in systemic autoimmune and inflammatory diseases: A review. Surv Ophthalmol. 2019;64(6):757-769.

9. Agrawal R, Ding J, Sen P, et al. Exploring choroidal angioarchitecture in health and disease using choroidal vascularity index. Prog Retin Eye Res. 2020;77:100829. doi:10.1016/j.preteyeres.2020.100829
10. Singh RB, Perepelkina T, Testi I, et al. Imaging-based assessment of choriocapillaris: A comprehensive review. Semin Ophthalmol. 2023;38(5):405-426.
11. Uslu Dogan C, Culha D. Subfoveal choroidal thickness and peripapillary retinal nerve fiber layer thickness in young obese males. Eur J Ophthalmol. 2021;31(6):3190-3195.
12. Özen B, Öztürk H, Çatlı G, Dündar B. Does obesity affect the ocular choroid tissue in children and adolescents? The Journal of Pediatric Research. 2018;5(3):112-117.
13. Bulut E, Köprübaşı S, Dayi Ö, Bulut H. Clinical relevance of choroidal thickness in obese and healthy children: A machine learning study. Turk J Ophthalmol. 2023;21;53(3):161-168.
14. Neyzi O, Bundak R, Gökçay G, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol. 2015;7(4):280-293.
15. Agrawal R, Jain M, Khan R, et al. Choroidal structural changes in sympathetic ophthalmia on swept-source optical coherence tomography. Ocul Immunol Inflamm. 2021;3;29(3):537-542.
16. Xiong S, He X, Zhang B, et al. Changes in Choroidal thickness varied by age and refraction in children and adolescents: A 1-year longitudinal study. Am J Ophthalmol. 2020;213:46-56. doi:10.1016/j.ajo.2020.01.003
17. Kara O, Altintas O, Karaman S, Emre E, Caglar Y. Analysis of Choroidal Thickness Using Spectral-Domain OCT in Children With Unilateral Amblyopia. J Pediatr Ophthalmol Strabismus. 2015;52(3):159-166.
18. Yao Y, Fu J, Liu J, Li L, Chen W, Meng Z. Assessment of macular choroidal and retinal thickness: a cohort study in Tibetan healthy children. Sci Rep. 2024;16;14(1):1383. doi:10.1038/s41598-024-51949-0
19. Muhiddin HS, Mayasari AR, Umar BT, et al. Choroidal thickness in correlation with axial length and myopia degree. Vision (Basel). 2022;6(1):16. doi:10.3390/vision6010016
20. Xie R, Qiu B, Chhablani J, Zhang X. Evaluation of choroidal thickness using optical coherent tomography: A Review. Front Med (Lausanne). 2021;8:783519. doi:10.3389/fmed.2021.783519
21. Teberik K, Eski MT, Doğan S, Pehlivan M, Kaya M. Ocular abnormalities in morbid obesity. Arq Bras Oftalmol. 2019;82(1):6-11.
22. Baran RT, Baran SO, Toraman NF, Filiz S, Demirbilek H. Evaluation of intraocular pressure and retinal nerve fiber layer, retinal ganglion cell, central macular thickness, and choroidal thickness using optical coherence tomography in obese children and healthy controls. Niger J Clin Pract. 2019;22(4):539-545.
23. Gonul S, Yilmaz H, Gedik S, Ozturk BT, Oflaz AB, Sahin M. Evaluation of the choroidal thickness and retinal nerve fiber layer and visual fields in morbid obesity: Does bariatric surgery affect retinal structure and function? Indian J Ophthalmol. 2021;69(2):301-306.
24. Bulus AD, Can ME, Baytaroglu A, Can GD, Cakmak HB, Andiran N. Choroidal thickness in childhood obesity. Ophthalmic Surg Lasers Imaging Retina. 2017;1;48(1):10-17.
25. Iovino C, Pellegrini M, Bernabei F, et al. Choroidal vascularity index: An in-depth analysis of this novel optical coherence tomography parameter. J Clin Med. 2020;21;9(2):595. doi:10.3390/jcm9020595
26. Betzler BK, Ding J, Wei X, et al. Choroidal vascularity index: a step towards software as a medical device. Br J Ophthalmol. 2022;106(2):149-155.
27. Iantorno M, Campia U, Di Daniele N, et al. Gut hormones and endothelial dysfunction in patients with obesity and diabetes. Int J Immunopathol Pharmacol. 2014;27(3):433-436.
28. Baretella O, Chung SK, Barton M, Xu A, Vanhoutte PM. Obesity and heterozygous endothelial overexpression of prepro-endothelin-1 modulate responsiveness of mouse main and segmental renal arteries to vasoconstrictor agents. Life Sci. 2014;24;118(2):206-212.