Ocular abnormalities in morbid obesity

ABSTRACT Purpose: Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] ³40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 mm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 mm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 mm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mm, and nasal 500, 1000, and 1500 mm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.

摘要 研究目的：肥胖与眼部疾病存在关联，但潜在的结构改变与致病机制尚未得到详尽阐释。本研究旨在评估病态肥胖对眼部疾病形态学指标的影响。方法：本研究纳入101名病态肥胖志愿者（体重指数[BMI]≥40）与95名健康个体（BMI：18.50~24.99），采用戈德曼压平眼压计（Goldmann applanation tonometry）、角膜测厚术（pachymetry）及频域光学相干断层扫描（spectral domain optical coherence tomography）完成检测。对两组受试者的眼压、前房深度、眼轴长度、中央角膜厚度、视网膜神经纤维层厚度、中心凹厚度及脉络膜厚度开展组间比较分析。结果：病态肥胖组的未校正眼压显著高于健康对照组（15.5±2.5 vs 14.5±2.6 mmHg，p=0.009）；两组眼轴长度、前房深度及中央角膜厚度无显著组间差异。病态肥胖组颞侧象限的平均视网膜神经纤维层厚度较对照组降低（72.7±13.6 较 85.05±52.6 mm，p=0.024）。同样，鼻侧与颞侧1500mm位置的平均视网膜厚度在病态肥胖组中较对照组更低（346.6±18.2 较 353.7±18.8 mm，p=0.008；323.1±20.3 较 330.0±18.9 mm，p=0.001）。病态肥胖组几乎所有测量点位（中心凹、颞侧500mm、1000mm及鼻侧500mm、1000mm、1500mm）的平均脉络膜厚度均显著降低（p<0.05）。体重与BMI与中心凹下脉络膜厚度呈负相关（r=-0.186，p=0.009；r=-0.173，p=0.015）。结论：病态肥胖与未校正眼压升高及神经病变、视网膜病变征象相关。因此，肥胖可能升高青光眼及青光眼性视神经病变的发病风险。