Inner retinal structure and intraocular pressure in children with obesity

Area of Science:

• Ophthalmology
• Pediatric Endocrinology
• Medical Imaging

Background:

• Pediatric obesity is a growing public health concern.
• Obesity is associated with systemic metabolic changes, including insulin resistance.
• Ophthalmic structural changes and intraocular pressure (IOP) alterations may be linked to obesity and metabolic dysfunction.

Purpose of the Study:

• To investigate the association between pediatric obesity and inner retinal structure, and intraocular pressure (IOP).
• To explore if insulin resistance (IR) is linked to additional ophthalmic differences within the obese subgroup.

Main Methods:

• Cross-sectional study of 202 children (92 obese, 110 controls), aged 6-18 years.
• Spectral-domain OCT used for retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness; rebound tonometry for IOP.
• Statistical models adjusted for age, sex, axial length, and spherical equivalent; sensitivity analyses included magnification correction.

Main Results:

• Obesity associated with higher IOP (2.48 mmHg difference) and reduced RNFL thickness, which attenuated after ocular biometry adjustments.
• RNFL differences were sensitive to biometry and magnification correction; only temporal RNFL remained significant after initial adjustments.
• GCIPL thickness did not differ significantly; IR and biochemical markers showed no independent association with OCT or IOP parameters in obese children.

Conclusions:

• Pediatric obesity is associated with elevated IOP, robust to ocular biometry adjustments.
• RNFL changes in obese children are influenced by axial length and magnification.
• Inner retinal layers (GCIPL) and insulin resistance did not show significant independent associations with ophthalmic parameters in this cohort.