Changes in ocular pulse amplitude and choroidal thickness in childhood obesity patients with and without insulin resistance

Inventory of Ocular Pulse Amplitude Values in Healthy Subjects and Patients With Ophthalmologic Illnesses: Systematic Review and Meta-analysis

PURPOSE

Many studies have examined the ocular pulse amplitude (OPA) to better understand its physiology and clinical relevance, but the papers are scattered, not consistently indexed, and sometimes difficult to locate. We aimed to identify and summarize the relevant published evidence on OPA and, in a meta-analysis, outline specific differences of this parameter between healthy individual, primary open-angle glaucoma, normal-tension glaucoma, ocular hypertension, and cataract patients.

DESIGN

Systematic review and meta-analysis.

METHODS

A thorough literature search and data extraction were conducted by 2 reviewers independently. Reports on OPA measured by the dynamic contour tonometry in conjunction with different ocular and systemic diseases or potential influencing factors were included.

RESULTS

Of the 527 initially found reports, 97 met the inclusion criteria assessing 31 clinical conditions. A meta-analysis based on 6850 eyes and 106 study arms (68.8%) revealed differences in mean OPA values in millimeters of mercury between various entities. Among healthy eyes, the OPA was 2.58 mm Hg (95% CI: 2.45-2.71), whereas OPA values were higher in glaucoma (unspecified glaucoma 2.73 mm Hg, 95% CI: 2.38-3.08; normal-tension glaucoma 2.66 mm Hg, 95% CI: 2.36-2.97; and primary open-angle glaucoma 2.92 mm Hg, 95% CI: 2.75-3.08). Although ocular hypertension showed the highest OPA values (3.53 mm Hg, 95% CI: 3.05-4.01), the lowest values were found in cataract eyes (2.26 mm Hg, 95% CI: 1.57-2.94).

CONCLUSION

We found different OPA values characteristic of different clinical entities, with above-normal values in glaucoma and ocular hypertension and lower values in cataract patients. Our work is intended for clinicians and researchers who want to get a quick overview of the available evidence or who need statistical data on OPA distributions in individual diseases.

Obesity-induced ocular changes in children and adolescents: A review

Childhood obesity has reached epidemic levels worldwide. Overweight and obesity is associated with an increase in several inflammatory markers, leading to chronic low-grade inflammation responsible for macro- and microvascular dysfunction. While the impact of obesity on overall health is well-described, less is known about its ocular manifestations. Still, there are few studies in children and adolescents in this regard and they are inconsistent. However, some evidence suggests a significant role of overnutrition in the development of changes in retinal microvasculature parameters (wider venules, narrower arterioles, lower arteriovenous ratio). Higher values of intraocular pressure were found to be positively correlated with high body mass index (BMI) as well as obesity. In addition, the retinal nerve fiber layer (RNFL) values seem to be lower in obese children, and there is a significant negative correlation between RNFL values and anthropometric and/or metabolic parameters. Changes also could be present in macular retinal thickness and choroidal thickness as well as in the retinal vessel density in children with obesity. However, these associations were not consistently documented. The purpose of this review is to present the most current issues on child obesity and the related potential ocular effects through an overview of international publications from the years 1992-2022.