Reduced retinal nerve fibre layer thickness in children with severe obesity
J Pacheco-Cervera1, P Codoñer-Franch2,3, R Simó-Jordá2
1Department of Ophthalmology, Doctor Peset University Hospital, Valencia, Spain.
Insights
Childhood obesity is linked to thinner retinal nerve fiber layers (RNFL), a potential indicator of optic nerve damage. This suggests obesity-related inflammation may harm retinal ganglion cells in children.
Area of Science:
- Ophthalmology
- Pediatrics
- Endocrinology
Background:
- Optic nerve diseases can be asymptomatic.
- Reduced retinal nerve fiber layer (RNFL) thickness is linked to increased body mass index in adults.
- Childhood obesity is a growing public health concern.
Purpose of the Study:
- To investigate the association between childhood obesity and RNFL thickness.
- To assess if obesity-related factors correlate with RNFL changes in children.
Main Methods:
- Included 97 children aged 5-14 years, categorized by BMI standard deviation score (SDS-BMI).
- Analyzed metabolic risk parameters, adipocytokines (leptin, adiponectin), and interleukin-6.
- Performed comprehensive ophthalmologic examinations and RNFL evaluation using optical coherence tomography.
Main Results:
- Severely obese children (SDS-BMI > 4) exhibited decreased average, inferior, superior, and nasal RNFL thickness compared to other groups.
- No significant association was found between obesity groups and temporal RNFL thickness.
- A significant inverse correlation was observed between RNFL thickness and adiposity indices, leptin, and interleukin-6 in overweight and obese children.
Conclusions:
- Adiposity and obesity-related inflammation may contribute to retinal ganglion cell loss in children.
- Findings highlight a potential link between metabolic health and ocular structures in pediatric populations.
- Early identification of RNFL changes in obese children could inform preventative strategies for eye health.
Background:
Some optic nerve diseases are silent and insidious. Recently, reduced thickness of retinal nerve fibre layer (RNFL) has been associated with increasing body mass index in adults.
Objectives:
To investigate the association of childhood obesity with RNFL measured by optical coherence tomography imaging.
Methods:
Ninety-seven children aged 5-14 years classified according to standard deviation score of body mass index (SDS-BMI) were included. Parameters of metabolic risk, adipocytokines (leptin, adiponectin) and interleukin-6 were analyzed. All subjects underwent a comprehensive ophthalmologic examination with direct ophthalmoscopy. Evaluation of RNFL with optical coherence tomography of the head of the nerve was performed.
Results:
RNFL thickness on the average and inferior, superior and nasal quadrants were decreased in severely obese children (SDS-BMI > 4) with respect to the other groups. However, no statistically significant association was found between the different groups of children and RNFL thickness in the temporal quadrant. There was a significant inverse correlation of RNFL thickness with adiposity indices (P = 0.016), leptin (P = 0.029) and interleukin-6 (P = 0.030) in overweight and obese children.
Conclusions:
These findings suggest that adiposity and obesity-related inflammatory factors may be associated with the loss of retinal ganglion cells in children.
Related Concept Videos
Diabetic Retinopathy
Photoreceptors and Visual Pathways


