Anormalidades oculares na obesidade mórbida

Teberik, Kuddusi; Eski, M. Tahir; Doğan, Sami; Pehlivan, Mevlüt; Kaya, Murat

doi:10.5935/0004-2749.20190007

Acessibilidade / Reportar erro

Brasil

Arquivos Brasileiros de Oftalmologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Arq. Bras. Oftalmol. 82 (1) • Jan-Feb 2019 • https://doi.org/10.5935/0004-2749.20190007 copiar

Anormalidades oculares na obesidade mórbida

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

A obesidade está associada a doenças oulares, mas as mudanças estruturais subjacentes e os mecanismos patogênicos não foram examinados detalhadamente. Aqui avaliamos os efeitos da obesidade mórbida nos índices morfométricos da doença ocular.

Métodos:

Voluntários obesos mórbidos (n=101, índice de massa corporal ³40) e indivíduos saudáveis (n=95, índice de massa corporal 18,50 a 24,99) foram examinados por tonometria de aplanação de Goldman, paquimetria e tomografia de coerência óptica de domício espectral. A pressão intraocular, profundidade da câmara anterior, comprimento axial, espessura central da córnea, espessura da camada de fibras nervosas da retina, espessura foveal central e espessura da coroide foram comparadas entre os grupos.

Resultados:

A pressão intraocular não corrigida foi significativamente maior no grupo com obesidade mórbida do que no grupo controle saudável (15,5 ± 2,5 vs. 14,5 ± 2,6 mmHg, p=0,009), enquanto que o comprimento axial, profundidade da câmara anterior e espessura central da córnea não diferiram entre os grupos. A espessura média da camada de fibras nervosas da retina no quadrante temporal foi reduzida no grupo com obesidade mórbida (72,7 ± 13,6 vs. 85,05 ± 52,6 mm, p=0,024). Da mesma forma, a média das espesuras da retinianas nas localizações nasal e temporal de 1500 m foi menor no grupo com obesidade mórbida (346,6 ± 18,2 mm vs. 353,7 ± 18,8 mm, p=0,008; 323,1 ± 20,3 mm vs. 330,0 ± 18,9 mm, p=0,001). A espessura média da coroide também foi reduzida em quase todos os locais de mensuração (fóvea, temporal 500 e 1000 mm, nasal 500, 1000 e 1500 mm) do grupo obeso (p<0,05). Peso e índice de massa corporal foram negativamente correlacionados com a espessura da coroide subfoveal (r=-0,186, p=0,009; r=-0,173, p=0,015).

Conclusão:

A obesidade mórbida está associada à elevada pressão intraocular não corrigida e a sinais de neuropatia e retinopatia. A obesidade pode, assim, aumentar os riscos de glaucoma e neuropatia óptica glaucomatosa.

Descritores:
Obesidade morbida; Pressão intraocular; Fibras nervosas; Paquimetria corneana; Segmento anterior do olho; Segmento posterior do olho

Parameters	Obese	Control	p-value
Age (years)	035.9 ± 11.5	036.6 ± 11.8	0.675
Body mass index (kg/m²)	048.6 ± 40.7	022.0 ± 01.4	0.001
Intraocular pressure (uncorrected) (mmHg)	015.5 ± 02.5	014.5 ± 02.6	0.009
Intraocular pressure (corrected) (mmHg)	014.6 ± 02.5	014.2 ± 02.2	0.208
Central corneal thickness (μm)	551.9 ± 31.3	544.4 ± 30.8	0.096
Axial length (mm)	022.8 ±0 2.1	022.9 ± 00.8	0.609
Anterior chamber depth (mm)	003.1 ± 00.4	003.1 ± 00.4	0.911

Quadrant (μm)	Obese	Control	p-value
Temporal	072.7 ± 13.6	085.05 ± 52.6	0.024
Temporal-superior	143.9 ± 24.4	138.30 ± 23.4	0.108
Temporal-inferior	148.7 ± 23.5	142.80 ± 22.8	0.078
Nasal	079.9 ± 17.3	081.90 ± 18.1	0.434
Nasal-superior	113.7 ± 25.6	117.10 ± 20.9	0.309
Nasal-inferior	115.0 ± 26.8	111.20 ± 23.9	0.300
Global	103.3 ± 12.0	104.80 ± 15.9	0.467

Location	Choroidal thickness (μm)			Retinal thickness (μm)
Location	Obese (n=101)	Control (n=95)	p	Obese (n=101)	Control (n=95)	p
Foveal	329.60 ± 67.1	360.2 ± 118.3	0.026	222.8 ± 23.0	223.1 ± 18.3	0.926
Temporal 500 μm	330.80 ± 66.0	358.7 ± 113.0	0.035	283.7 ± 25.0	288.4 ± 27.3	0.215
Temporal 1000 μm	321.70 ± 63.2	347.4 ± 108.3	0.042	327.1 ± 19.4	332.0 ± 22.4	0.104
Temporal 1500 μm	314.10 ± 60.0	333.4 ± 107.0	0.119	323.1 ± 20.3	330.0 ± 18.9	0.001
Nasal 500 μm	318.40 ± 70.2	349.6 ± 118.6	0.025	300.0 ± 29.2	299.8 ± 30.8	0.956
Nasal 1000 μm	305.30 ± 70.4	348.9 ± 113.2	0.001	341.5 ± 27.5	347.4 ± 23.0	0.105
Nasal 1500 μm	286.48 ± 70.3	323.5 ± 114.1	0.006	346.6 ± 18.2	353.7 ± 18.8	0.008

	r	p
Uncorrected intraocular pressure	-0.167	0.020
Corrected intraocular pressure	-0.107	0.135
Central corneal thickness	-0.071	0.322
Axial length	-0.030	0.672
Anterior chamber depth	-0.025	0.728

	Subfoveal	T500	T1000	T1500	N500	N1000	N1500
Weight
r	-0.186^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.189^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.176^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.156^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.181^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.249^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.231^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.
p	-0.009^† † correlation is significant at the 0.01 level (2-tailed);	0.008^† † correlation is significant at the 0.01 level (2-tailed);	*-0.014^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.029^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.011^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	-0.001^† † correlation is significant at the 0.01 level (2-tailed);	0.001^† † correlation is significant at the 0.01 level (2-tailed);
Height
r	-0.069^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.071^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.037^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.056^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.037^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.073^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.116
p	*-0.340^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.320^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.604^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.435^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.603^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.311^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.107^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**
BMI
r	-0.173^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.176^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.172^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.150^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.180^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.237^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.	-0.208^* * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.
p	*-0.015^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.014^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.016^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.036^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	*-0.011^ * correlation is significant at the 0.05 level (2-tailed); r= correlation coefficient.**	-0.001^† † correlation is significant at the 0.01 level (2-tailed);	-0.003^† † correlation is significant at the 0.01 level (2-tailed);

Conselho Brasileiro de Oftalmologia Rua Casa do Ator, 1117 - cj.21, 04546-004 São Paulo SP Brazil, Tel: 55 11 - 3266-4000, Fax: 55 11- 3171-0953 - São Paulo - SP - Brazil
E-mail: abo@cbo.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Kuddusi Teberik. E-mail: kuddusiteberik@yahoo.com