Ramazan İlyas Öner1, Ayşe Sevgi Karadağ2. 1. Department of Internal Medicine, Faculty of Medicine, Adiyaman University, Adıyaman, Turkey. 2. Department of Eye Disease, Faculty of Medicine, Adiyaman University, Adıyaman, Turkey.
Abstract
PURPOSE: We aimed to evaluate choroidal per-fusion changes in obese patients using optical coherence tomography and dynamic contour tonometry, to determine whether these changes are associated with body mass index, and to assess the ocular effects of insulin resistance. METHODS: We retrospectively evaluated the data of 32 obese patients with body mass index >30 kg/m2 and 45 healthy control individuals. Intraocular pressure and ocular pulse amplitude values of the patients were measured using dynamic contour tonometry, and the mean choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Insulin resistance was assessed using the homeostasis model assessment-estimated insulin resistance index. RESULTS: The mean choroidal thickness (294.30 ± 60.87 μm) and ocular pulse amplitude (2.10 ± 0.74) were lower, whereas the mean intraocular pressure (16.61 ± 2.35 mmHg) was higher in obese patients than in controls. There was a significant negative correlation between body mass index and ocular pulse amplitude (r=-0.274; p=0.029) and an insignificant negative correlation between mean choroidal thickness, intraocular pressure, and body mass index. There was an insignificant negative correlation between homeostasis model assessment-estimated insulin resistance index, mean choroidal thickness, and intraocular pressure and significant ne-gative correlation between homeostasis model assessment-estimated insulin resistance index and ocular pulse amplitude (r=-0.317; p=0.022). CONCLUSION: We found reduced mean choroidal thickness and ocular pulse amplitude and increased mean intraocular pressure in obese patients. These changes indicated a decrease in choroidal perfusion and ocular blood flow. It may be possible to detect ocular blood flow changes in obese patients through noninvasive assessment using the choroid. The negative correlation between insulin resistance and ocular pulse amplitude may be associated with intracellular fat accumulation in obese patients.
PURPOSE: We aimed to evaluate choroidal per-fusion changes in obesepatients using optical coherence tomography and dynamic contour tonometry, to determine whether these changes are associated with body mass index, and to assess the ocular effects of insulin resistance. METHODS: We retrospectively evaluated the data of 32 obesepatients with body mass index >30 kg/m2 and 45 healthy control individuals. Intraocular pressure and ocular pulse amplitude values of the patients were measured using dynamic contour tonometry, and the mean choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Insulin resistance was assessed using the homeostasis model assessment-estimated insulin resistance index. RESULTS: The mean choroidal thickness (294.30 ± 60.87 μm) and ocular pulse amplitude (2.10 ± 0.74) were lower, whereas the mean intraocular pressure (16.61 ± 2.35 mmHg) was higher in obesepatients than in controls. There was a significant negative correlation between body mass index and ocular pulse amplitude (r=-0.274; p=0.029) and an insignificant negative correlation between mean choroidal thickness, intraocular pressure, and body mass index. There was an insignificant negative correlation between homeostasis model assessment-estimated insulin resistance index, mean choroidal thickness, and intraocular pressure and significant ne-gative correlation between homeostasis model assessment-estimated insulin resistance index and ocular pulse amplitude (r=-0.317; p=0.022). CONCLUSION: We found reduced mean choroidal thickness and ocular pulse amplitude and increased mean intraocular pressure in obesepatients. These changes indicated a decrease in choroidal perfusion and ocular blood flow. It may be possible to detect ocular blood flow changes in obesepatients through noninvasive assessment using the choroid. The negative correlation between insulin resistance and ocular pulse amplitude may be associated with intracellular fat accumulation in obesepatients.
Authors: Arnaldo Dias-Santos; Joana Tavares Ferreira; Sofia Pinheiro; João Paulo Cunha; Marta Alves; Ana Luísa Papoila; Maria Francisca Moraes-Fontes; Rui Proença Journal: Clin Ophthalmol Date: 2019-08-20