Evaluation of retinochoroidal microvascular parameters and biochemical markers in childhood obesity.

PURPOSE: To evaluate retinochoroidal microvascular changes and their association with biochemical parameters in children with obesity. METHODS: This cross-sectional study included 100 children aged 6-15 years (50 obese, 50 normal weight). Retinal parameters superficial and deep capillary plexuses (SCP, DCP), choriocapillaris (CC), foveal avascular zone (FAZ), ganglion cell layer (GCL), and retinal nerve fiber layer (RNFL) were assessed using OCT and OCTA. Biochemical measures, including HDL, LDL, triglycerides, glucose, insulin, and blood pressure, were recorded. Associations between vascular density and biochemical variables were analyzed using regression analysis. RESULTS: Obese children showed a significantly smaller FAZ area than controls (262.11 ± 60.33 μm2 vs 316.47 ± 67.09 μm2, p < 0.001). RNFL thickness was significantly reduced in the central region (9.35 ± 5.51 μm vs 11.25 ± 4.65 μm, p = 0.041). GCL thickness was significantly lower in the temporal (81.55 ± 10.07 μm vs 87.42 ± 9.81 μm, p = 0.022) and inferior regions (85.73 ± 13.29 μm vs 92.69 ± 10.06 μm, p = 0.028). No significant differences were observed in SCP, DCP, or CC vessel densities. Foveal SCP and DCP vessel densities were negatively associated with systolic blood pressure and positively associated with HDL cholesterol. CONCLUSIONS: Childhood obesity is associated with FAZ reduction and thinning of retinal neural layers. Retinal microvascular findings may reflect the influence of vascular and metabolic risk factors in pediatric obesity.