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Updated: Jun 2, 2025

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
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HOMA-IR value in predicting retinal microvascular dysfunction.

Seskoati Prayitnaningsih1,2, Kristina Yuniasih1,2, Intan Kautsarani1,2

  • 1Department of Ophthalmology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.

Narra J
|January 16, 2025
PubMed
Summary
This summary is machine-generated.

Obesity is linked to retinal microvascular dysfunction. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score shows promise as a biomarker for predicting this dysfunction in obese patients.

Keywords:
HOMA-IRbiomarkercapillary perfusionflux indexinsulin resistance

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Vascular Biology

Background:

  • Obesity is associated with microvascular dysfunction, impacting visual acuity.
  • Retinal microvascular changes, particularly in the optic nerve head (ONH), are implicated in visual impairment.
  • Insulin resistance is a common metabolic abnormality in obesity.

Purpose of the Study:

  • To investigate the relationship between the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score and ONH microvascular dysfunction (capillary perfusion and flux index) in obese patients.
  • To evaluate the diagnostic performance of HOMA-IR in predicting retinal vascular dysfunction.

Main Methods:

  • A case-control study involving 160 obese and non-obese individuals.
  • Insulin resistance assessed using HOMA-IR derived from fasting glucose and insulin levels.
  • Optical coherence tomography angiography (OCT-A) used to measure ONH capillary perfusion and flux index.
  • Pearson's correlation, ROC curve analysis, and logistic regression employed for statistical analysis.

Main Results:

  • HOMA-IR scores significantly negatively correlated with ONH capillary perfusion in superior, inferior, and outer regions.
  • HOMA-IR scores significantly negatively correlated with ONH flux index in superior, inferior, nasal, and outer regions.
  • A HOMA-IR cutoff of 5.51 demonstrated an AUC of 0.819 for detecting vascular dysfunction, with significant associations found in multiple ONH regions.

Conclusions:

  • HOMA-IR is a potential biomarker for identifying retinal microvascular dysfunction in obese individuals.
  • The study highlights a significant link between insulin resistance and impaired ONH vascular function.
  • HOMA-IR offers a non-invasive method to assess the risk of vision-threatening complications in obesity.