肥胖对眼部血流动力学和脉络膜厚度的影响。

The impact of obesity on ocular hemodynamics and choroidal thickness.

作者信息

Tufek Melek, Nalcacioglu Pinar, Capraz Mustafa, Varol Kenan, Kaya Ahmet Turan, Aydın Nihat, Kara Caner

机构信息

Department of Ophthalmology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Kirazlıdere Mahallesi, Asya Sokak, Amasya, Eyalet/Yerleske 05100, Turkey.

Department of Ophthalmology, Yildirim Beyazit University Medical School, Ankara, Turkey.

出版信息

Ther Adv Ophthalmol. 2023 Jun 30;15:25158414231180985. doi: 10.1177/25158414231180985. eCollection 2023 Jan-Dec.

DOI:10.1177/25158414231180985

PMID:37441618

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10333989/

Abstract

BACKGROUND

Obesity affects microvascular structures. The effect of obesity on the ocular vascular system can be evaluated by changes in the choroidal thickness (CT) and retrobulbar blood flow (RBF).

OBJECTIVES

To evaluate the CT and RBF parameters in obese patients with various body mass index (BMI) values and compare these parameters with normal weight, healthy subjects.

DESIGN

A prospective study.

METHODS

The study included 102 eyes of 102 female patients. Patients were divided into three groups according to BMI as group 1 with a BMI of 18.5-24.99 ( = 32), normal weight group; group 2 with a BMI of 30-34.99 ( = 35), as obese class I; and group 3 with a BMI of 35-39.99 ( = 35), as obese class II. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index, and pulsatility index values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography. CT was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm by using the enhanced depth imaging technique of optical coherence tomography. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometry.

RESULTS

There was a significant difference in IOP values within the groups with the highest values in group 3 (17.6 ± 2.1 mmHg) and the lowest in group 1 (12.4 ± 1.7 mmHg). The CT in groups 2 and 3 was found to be statistically significantly lower than that in group 1 at all measurement points ( < 0.001). There was a statistically significant negative correlation between CT at all measurement points and BMI ( < 0.001). The mean CRA PSV, EDV, and OA EDV values were statistically significantly lower in each obese group than those values in group 1 ( < 0.001). The OA PSV values were significantly lower in group 3 (36.5 ± 5.9 cm/s) than those in group 2 (43.8 ± 4 cm/s) and group 1 (44.6 ± 5.2 cm/s) ( < 0.001). Also, significant associations were found between BMI and CRA PSV, CRA EDV, and OA PSV values ( < 0.001).

CONCLUSION

Obesity may predispose to eye pathologies by changing the ocular vascular circulation.

摘要

背景

肥胖会影响微血管结构。肥胖对眼部血管系统的影响可通过脉络膜厚度（CT）和球后血流（RBF）的变化来评估。

目的

评估不同体重指数（BMI）值的肥胖患者的CT和RBF参数，并将这些参数与正常体重的健康受试者进行比较。

设计

一项前瞻性研究。

方法

该研究纳入了102名女性患者的102只眼睛。根据BMI将患者分为三组：1组BMI为18.5 - 24.99（n = 32），为正常体重组；2组BMI为30 - 34.99（n = 35），为I级肥胖组；3组BMI为35 - 39.99（n = 35），为II级肥胖组。采用彩色多普勒超声评估视网膜中央动脉（CRA）和眼动脉（OA）的收缩期峰值速度（PSV）、舒张末期速度（EDV）、阻力指数和搏动指数值。使用光学相干断层扫描的增强深度成像技术在黄斑中心凹下区域以及距中心凹鼻侧和颞侧500μm间隔处直至1500μm距离测量CT。用Goldmann压平眼压计测量眼压（IOP）。

结果

组内IOP值存在显著差异，3组最高（17.6 ± 2.1 mmHg），1组最低（12.4 ± 1.7 mmHg）。在所有测量点，2组和3组的CT均显著低于1组（P < 0.001）。所有测量点的CT与BMI之间存在显著的负相关（P < 0.001）。每个肥胖组的CRA平均PSV、EDV和OA的EDV值均显著低于1组（P < 0.001）。3组的OA PSV值（36.5 ± 5.9 cm/s）显著低于2组（43.8 ± 4 cm/s）和1组（44.6 ± 5.2 cm/s）（P < 0.001）。此外，BMI与CRA PSV、CRA EDV和OA PSV值之间存在显著关联（P < 0.001）。