Free papers detail | 11th Asia Pacific Tele Ophthalmology Society Symposium

Title
Association of Obesity Duration with Optic Nerve Morphology: A 14-Year Longitudinal Cohort Study

Authors
Xi Chen

Presenting
Xi Chen

PURPOSE:
The cumulative effects of obesity duration on optic nerve morphology remain unclear. This study aimed to investigate the dose-response association and the mediating role of cerebrospinal fluid pressure (CSFP).

METHODS:
This longitudinal cohort study included 674 participants from the Kailuan Eye Study. Obesity duration was defined as the cumulative number of visits with obesity (BMI ≥ 28 kg/m²) across 8 examinations (2006–2020). Optic nerve morphology was quantified using deep learning-based MRI analysis. Multivariable linear regression, restricted cubic splines, and mediation analysis were used to assess associations.

METHODS:

This longitudinal cohort study included 674 participants from the Kailuan Eye Study. Obesity duration was defined as the cumulative number of visits with obesity (BMI ≥ 28 kg/m²) across 8 examinations (2006–2020). Optic nerve morphology was quantified using deep learning-based MRI analysis. Multivariable linear regression, restricted cubic splines, and mediation analysis were used to assess associations.

RESULTS:
The mean age of the participants was 53.6 years (51.0% men). Greater obesity duration was significantly associated with increased mean optic nerve cross-sectional area (β = 0.396, P < 0.001) and tortuosity (β = 1.536, P = 0.013) after multivariable adjustment. A linear dose-response relationship was observed without a threshold. A marginal age interaction was observed (P for interaction = 0.063), with a stronger effect size in participants younger than 60 years. Mediation analysis indicated that 45.58% of the total effect was mediated by estimated CSFP.

RESULTS:

The mean age of the participants was 53.6 years (51.0% men). Greater obesity duration was significantly associated with increased mean optic nerve cross-sectional area (β = 0.396, P < 0.001) and tortuosity (β = 1.536, P = 0.013) after multivariable adjustment. A linear dose-response relationship was observed without a threshold. A marginal age interaction was observed (P for interaction = 0.063), with a stronger effect size in participants younger than 60 years. Mediation analysis indicated that 45.58% of the total effect was mediated by estimated CSFP.

CONCLUSIONS:
Prolonged obesity duration is associated with dose-dependent optic nerve remodeling, mediated by elevated intracranial pressure, emphasizing the importance of early weight management.