Evaluation of the subfoveal choroidal and outer retinal layer thickness in obese women

Obesity has become one of the most important health problems of today with its increasing prevalence. With the development of retinal imaging systems, obesity has been observed to be associated with changes in outer retinal layers and choroid in women.

The aim of this study was to examine retinal layer parameters and their relationship with body mass index in obese women.

The study included 197 eyes of 197 women, of whom 44 were normal-weight, 40 were overweight, 40 were class 1 obese, 38 were class 2 obese, and 35 were morbidly obese. The thickness of the choroid was measured manually using an enhanced-depth imaging optical coherence tomography scanning program.

The mean choroidal thickness values in five locations were lower than those of normal-weight, overweight, class 1, and class 2 obese women, in morbidly obese women (p < 0.05 for all). Subfoveal outer retinal layer thickness and specific sublayer thickness of the photoreceptor layer values were significantly lower in morbidly obese women than in normal-weight women, but there were no statistically significant differences between the groups in retinal pigment epithelium thickness and Bruch's membrane thickness (p = 0.001, p < 0.001, p = 1.00, and p = 0.101, respectively). Furthermore, there were significant negative relationships between body mass index and subfoveal choroidal thickness, subfoveal outer retinal layer thickness, and specific sublayer thickness of the photoreceptor layer values (r = -0.327, p < 0.001; r = -0.259, p < 0.001; and r = -0.281, p < 0.001, respectively).

Morbid obesity was associated with a thinner choroid, subfoveal outer retinal layer, and specific sublayer thickness of the photoreceptor layer in women. Furthermore, retinal hypoxia associated with morbid obesity may be related to a decrease in photoreceptor layer thickness. Thinning of the outer retinal layer may also lead to atrophy of the cone sheath.