Comparison of retinal vascular geometry in obese and non-obese children

PURPOSE: Childhood obesity is associated with adult cardiometabolic disease. We postulate that the underlying microvascular dysfunction begins in childhood. We thus aimed to compare retinal vascular parameters between obese and non-obese children. METHODS: This was a cross-sectional study involving 166 children aged 6 to 12 years old in Malaysia. Ocular examination, biometry, retinal photography, blood pressure and body mass index measurement were performed. Participants were divided into two groups; obese and non-obese. Retinal vascular parameters were measured using validated software. RESULTS: Mean age was 9.58 years. Approximately 51.2% were obese. Obese children had significantly narrower retinal arteriolar caliber (F((1,159)) = 6.862, p = 0.010), lower arteriovenous ratio (F((1,159)) = 17.412, p < 0.001), higher venular fractal dimension (F((1,159)) = 4.313, p = 0.039) and higher venular curvature tortuosity (F((1,158)) = 5.166, p = 0.024) than non-obese children, after adjustment for age, gender, blood pressure and axial length. CONCLUSIONS: Obese children have abnormal retinal vascular geometry. These findings suggest that childhood obesity is characterized by early microvascular abnormalities that precede development of overt disease. Further research is warranted to determine if these parameters represent viable biomarkers for risk stratification in obesity.