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Editors Selection IGR 9-4

Intraocular pressure: IOP and obesity in children

Comment by Felipe Medeiros on:

20115 Relationship between intraocular pressure and obesity in children, Akinci A; Cetinkaya E; Aycan Z et al., Journal of Glaucoma, 2007; 16: 627-630

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Akinci et al. (1339) conducted an interesting study investigating the relationship between intraocular pressure and obesity in children. The authors measured IOP with Goldmann applanation tonometry (GAT) in 72 obese children (body mass index in the 95^th percentile or greater) and 72 age- and sex-matched controls. They found that the mean IOP in obese children was significantly higher than in the control group (17.9 ± 3.4 mmHg vs. 12.3 ± 2.6 mmHg for boys, and similar figures for girls) and an IOP greater than 21 mmHg was detected in almost 10% of obese children versus none of the controls. They also found significant higher measurements of systolic and diastolic blood pressure in obese children and speculated that the IOP increase could be secondary to the effect of obesity on blood pressure.

Although IOP was found to be elevated in obese children, this does not necessarily mean that obese children are at higher risk of developing the disease

The study raises many interesting questions: Would the increase in IOP in this age group be a risk factor for development of glaucoma? Although IOP was found to be elevated in obese children, this does not necessarily mean that obese children are at higher risk of developing the disease. Other factors could also play a role and influence the risk, such as changes in blood pressure and ocular perfusion pres-sure or perhaps the effects of caloric intake on the optic nerve. Also, there are some limitations on the methodology and data analysis of Akinci et al.'s study that preclude more definitive conclusions. First, it would have been useful to see a study of the relationship between BMI and IOP measurements. Are they correlated? Also, due to its known influence on GAT measurements, it would have been impor-tant to control for the possible confounding effect of central corneal thickness. In a recent population-based study in Japan, CCT showed a weak but significant relationship with body weight.¹ A recent study published on the New England Journal of Medicine linked obesity in children with a high risk of becoming obese and having coronary heart disease in adulthood.² Would these obese children also be at higher risk for glaucoma during their lifetime? Longitudinal studies will be necessary to help us answer these questions.

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