The Relationship of Body Mass Index and Blood Pressure with Corneal Biomechanical Parameters in Healthy Subjects

Mohamad-Reza Sedaghat, Farshad Askarizadeh, Mohsen Nematy, Foroozan Narooie-Noori, Javad Heravian, Tahereh Rakhshandadi, Sattar Rajabi


This study aimed to assess the possible relationship of body mass index (BMI) and blood pressure (BP) with corneal biomechanical parameters in healthy subjects. The study included 88 eyes of 88 healthy subjects aged 20–40 years. After a thorough medical history, a digital sphygmomanometer was used to measure the systolic blood pressure (SBP) and diastolic blood pressure (DBP). In addition, several hematological and biochemical parameters were determined to assess general health. Before the ophthalmic examination, the body height and weight were measured; then, the BMI was calculated. Finally, after comprehensive ophthalmic examination, all cases were evaluated with Pentacam (Oculus) in order to rule out corneal ectasia; then, the corneal biomechanical parameters of all individuals were measured using the Scheimpflug-based Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany). If the measurements of the hematological and biochemical parameters were within normal range, the results of the Corvis ST, BMI, and BP were included in the analysis carried out with SPSS software. The mean (± standard deviation [SD]) BMI, SBP, DBP, intraocular pressure (IOP), central corneal thickness (CCT), deformation amplitude, radius, and peak distance was 27.24 ± 4.80 kg/m2, 116.47 ± 11.21 mmHg, 80.51 ± 5.68 mmHg, 15.10 ± 1.70 mmHg, 533.10 ± 30.97 m, 1.03 ± 0.11 mm, 7.51 ± 0.86 mm, and 5.03 ± 0.30 mm, respectively. According to the World Health Organization’s classification of BMI, the results showed no significant difference in IOP, CCT, peak distance, radius, and deformation amplitude between different BMI subcategories (all P > 0.05). The results of the Corvis ST showed that corneal biomechanical parameters had no significant correlation with BMI, SBP, and DBP in three subgroups of BMI and all participants (all P > 0.05) but the results showed a positive correlation between CCT and IOP (P < 0.001, r = 0.504) in all participants. CCT and IOP had no correlation with BMI, SBP, and DBP (all P > 0.05). This study showed that BMI and BP had no correlation with corneal biomechanical parameters in healthy subjects using the Corvis ST. Our results can be used in clinical practice.



Garcia-Porta N, Fernandes P, Queiros A, Salgado-Borges J, Parafita-Mato M, Gonzalez-Meijome JM. Corneal biomechanical properties in different ocular conditions and new measurement techniques. ISRN Ophthalmol. 2014;2014:724546. DOI: 10.1155/2014/ 724546 PMID: 24729900

Roberts CJ. Concepts and misconceptions in corneal biomechanics. J Cataract Refract Surg. 2014;40(6):862-9. DOI: 10.1016/j.jcrs.2014.04.019 PMID: 24857435

Hollman KW, Shtein RM, Tripathy S, Kim K. Using an ultrasound elasticity microscope to map three-dimensional strain in a porcine cornea. Ultrasound Med Biol. 2013;39(8):1451-9. DOI: 10.1016/j.ultrasme dbio.2013.02.465 PMID: 23683407

Kotecha A. What biomechanical properties of the cornea are relevant for the clinician? Surv Ophthalmol. 2007;52 Suppl 2:S109-14. DOI: 10.1016/j.survopht hal.2007.08.004 PMID: 17998034

Pinero DP, Alcon N. In vivo characterization of corneal biomechanics. J Cataract Refract Surg. 2014;40(6):870-87. DOI: 10.1016/j.jcrs.2014.03.021 PMID: 24857436

Fontes BM, Ambrosio R, Jr., Alonso RS, Jardim D, Velarde GC, Nose W. Corneal biomechanical metrics in eyes with refraction of -19.00 to +9.00 D in healthy Brazilian patients. J Refract Surg. 2008;24(9):941-5. PMID: 19044236

Karadag R, Arslanyilmaz Z, Aydin B, Hepsen IF. Effects of body mass index on intraocular pressure and ocular pulse amplitude. Int J Ophthalmol. 2012;5(5):605-8. DOI: 10.3980/j.issn.2222-3959.2012.05.12 PMID: 2316 6873

George GO. Relationship between Body Mass Index, Intraocular Pressure, Blood Pressure and Age in Nigerian Population. J Clin Experim Ophthalmol. 2015;06(04). DOI: 10.4172/2155-9570.1000461

Kuang TM, Tsai SY, Hsu WM, Cheng CY, Liu JH, Chou P. Body mass index and age-related cataract: the Shihpai Eye Study. Arch Ophthalmol. 2005;123(8):1109-14. DOI: 10.1001/archopht.123.8.1109 PMID: 16087846

Cheung N, Wong TY. Obesity and eye diseases. Surv Ophthalmol. 2007;52(2):180-95. DOI: 10.1016/j.surv ophthal.2006.12.003 PMID: 17355856

van Leiden HA, Dekker JM, Moll AC, Nijpels G, Heine RJ, Bouter LM, et al. Blood pressure, lipids, and obesity are associated with retinopathy: the hoorn study. Diabetes Care. 2002;25(8):1320-5. PMID: 12145228

Seddon JM, Cote J, Davis N, Rosner B. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol. 2003;121(6):785-92. DOI: 10.1001/archopht.121.6.785 PMID: 12796248

Dua S, Bhuker M, Sharma P, Dhall M, Kapoor S. Body mass index relates to blood pressure among adults. N Am J Med Sci. 2014;6(2):89-95. DOI: 10.4103/1947-2714.127751 PMID: 24696830

Droyvold WB, Midthjell K, Nilsen TI, Holmen J. Change in body mass index and its impact on blood pressure: a prospective population study. Int J Obes (Lond). 2005;29(6):650-5. DOI: 10.1038/sj.ijo.0802944 PMID: 15809666

Elflein HM, Pfeiffer N, Hoffmann EM, Hoehn R, Kottler U, Lorenz K, et al. Correlations between central corneal thickness and general anthropometric characteristics and cardiovascular parameters in a large European cohort from the Gutenberg Health Study. Cornea. 2014;33(4):359-65. DOI: 10.1097/ICO.0000000000000 068 PMID: 24556853

Leung CK, Ye C, Weinreb RN. An ultra-high-speed Scheimpflug camera for evaluation of corneal deformation response and its impact on IOP measurement. Invest Ophthalmol Vis Sci. 2013;54(4):2885-92. DOI: 10.1167/iovs.12-11563 PMI D: 23482466

Attarzadeh Hosseini SR, Hejazi K. The effects of ramadan fasting and physical activity on blood hematological-biochemical parameters. Iran J Basic Med Sci. 2013;16(7):845-9. PMID: 23997915

Carney LG, Mainstone JC, Henderson BA. Corneal topography and myopia. A cross-sectional study. Invest Ophthalmol Vis Sci. 1997;38(2):311-20. PMID: 9040463

Hong J, Xu J, Wei A, Deng SX, Cui X, Yu X, et al. A new tonometer--the Corvis ST tonometer: clinical comparison with noncontact and Goldmann applanation tonometers. Invest Ophthalmol Vis Sci. 2013;54(1):659-65. DOI: 10.1167/iovs.12-10984 PMID: 23307970

Narayanaswamy A, Chung RS, Wu RY, Park J, Wong WL, Saw SM, et al. Determinants of corneal biomechanical properties in an adult Chinese population. Ophthalmology. 2011;118(7):1253-9. DOI: 10.1016/j. ophtha.2010.12.001 PMID: 21333357

Luz A, Faria-Correia F, Salomao MQ, Lopes BT, Ambrosio R, Jr. Corneal biomechanics: Where are we? J Curr Ophthalmol. 2016;28(3):97-8. DOI: 10.1016/ co.2016.07.004 PMID: 27579450

Tian L, Huang YF, Wang LQ, Bai H, Wang Q, Jiang JJ, et al. Corneal biomechanical assessment using corneal visualization scheimpflug technology in keratoconic and normal eyes. J Ophthalmol. 2014;2014:147516. DOI: 10.1155/2014/147516 PMID: 24800059

Bak-Nielsen S, Pedersen IB, Ivarsen A, Hjortdal J. Repeatability, reproducibility, and age dependency of dynamic Scheimpflug-based pneumotonometer and its correlation with a dynamic bidirectional pneumotonometry device. Cornea. 2015;34(1):71-7. DOI: 10.1097/ICO.0000000000000293 PMID: 253930 92

Cohen E, Kramer M, Shochat T, Goldberg E, Garty M, Krause I. Relationship Between Body Mass Index and Intraocular Pressure in Men and Women: A Population-based Study. J Glaucoma. 2016;25 (5):e509-13. DOI: 10.1097/IJG.0000000000000374 PM ID: 26766402

Fukuoka S, Aihara M, Iwase A, Araie M. Intraocular pressure in an ophthalmologically normal Japanese population. Acta Ophthalmol. 2008;86(4):434-9. DOI: 10.1111/j.1600-0420.2007.01068.x PMID: 18039350

Albuquerque LL, Gaete MI, Figueiroa JN, Alves JG. The correlation between body mass index and intraocular pressure in children. Arq Bras Oftalmol. 2013;76(1):10-2. PMID: 23812519

Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013;15(3):134-6. DOI: 10.1007/s1190 6-013-0340-9 PMID: 23536128

Ofori-Asenso R, Agyeman AA, Laar A, Boateng D. Overweight and obesity epidemic in Ghana-a systematic review and meta-analysis. BMC Public Health. 2016;16(1):1239. DOI: 10.1186/s12889-016-3901-4 PMID: 27938360

Howick J, Glasziou P, Aronson JK. Evidence-based mechanistic reasoning. J R Soc Med. 2010;103(11): 433-41. DOI: 10.1258/jrsm.2010.100146 PMID: 2103 7334

Full Text: Full Text PDF

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.