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Obesity and retinal vessels

In adults, it has been shown that changes in retinal vessels, specifically narrow arterioles and wide venules, are directly related to obesity and hypertension, and later adverse cardiovascular outcomes. Retinal photography is now automated and standardised, and it is relatively easy to screen large populations. As BMIs and blood pressures are rising progressively in the childhood population, could retinal vessels give a more precise indication of true cardiovascular risk? Researchers from Switzerland did a systematic review and came up with 22 articles involving nearly 19 000 non-diabetic children, whose retinae had been systematically examined (Köchli S et al. Pediatrics. doi: 10.1542/peds.2017–4090). Of these 11 could be combined for meta-analysis, and they showed a consistent correlation between high BMI and narrow arterioles (pooled effect −0.37; 95% CI −0.5 to −0.2) and wide venules (+0.35). Both systolic and diastolic blood pressure showed similar associations. There was weaker evidence for a beneficial association between increased physical activity and normal retinal vessel size. None of the studies looked at long-term outcomes.

We know that childhood obesity and hypertension track into adulthood, and that adult retinal changes predict poor health, and so it …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.