The Effect of Childhood Obesity on Intraocular Pressure, Corneal Biomechanics, Retinal Nerve Fiber Layer and Central Macular Thickness

Précis: Elevated corneal hysteresis (CH) and resistance factor (CRF) in obese and over-weight children imply weight’s effect on corneal biomechanics. Increased Goldmann-correlated intraocular pressure (IOPg) in obese indicates glaucoma risk, emphasizing screening for IOP, retinal changes. Purpose: To evaluate the effect of obesity on corneal biomechanics, retinal nerve fibre layer (RNFL) and central macular thicness (CMT) in children. Patients and Methods: In this prospective, cross-sectional, comparative study, 146 eyes of normal-weight, over-weight, and obese children aged between 6 to 17 years were evaluated. The IOPg, corneal compensated IOP (IOPcc), CH, CRF and the average retinal nerve fiber layer (RNFL), average cup-to-disk ratio (c/d), central macular thickness (CMT) were measured by Ocular Response Analyser and Spectral-Domain Optical Coherence Tomography (SD-OCT), respectively. Results: There was no statistically significant difference regarding age, sex, IOPcc, average RNFL thickness, c/d ratio, and CMT among the groups ( P ≥0.05). The IOPg was significantly higher in obese children compared to normal-weight children, while CH and CRF values were significantly higher in both obese and over-weight children compared to healthy ones ( P <0.05). There was a positive correlation between BMI percentile and IOPg, CH, and CRF values. Conclusion: In our study, higher IOPg, corneal hysteresis, and corneal resistance factor values suggest that obese children could be potential candidates for glaucoma. Therefore, it would be appropriate to screen them for IOP and retinal alterations. On the other hand, further investigations with larger sample sizes and longer follow-up periods are needed to eliminate the risk of glaucoma in obese children.