icalImaging     Ferial Zeried 1 , Ezinne Ngozika 2 , Mana Al-Anazi 3 , Khathutshelo Mashige 4 and Uchechukwu Osuagwu 5,* 1 Department of Optometry & Vision Sciences College of Applied Medical Sciences, King Saud University, Ilesha, Sau- di Arabia; 2 Department of Clinical Surgical Sciences, Optometry Unit, University of the West Indies, St Augustine Campus, Trinidad and Tobago; 3 African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Na- tal, Westville Campus, Durban, 3629, South Africa; 4 Diabetes, Obesity and Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW 2560, Australia; 5 Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia ARTICLE HISTORY Received: January 13, 2021 Revised: April 13, 2021 Accepted: April 20, 2021 DOI: 10.2174/1573405618666220131105957 Abstract: Background: Obesity is one of the major public health problems globally, especially among women. Obesity is associated with glaucoma, cataract, age-related macular degeneration and diabetic retinopathy. Although it is clear that the anatomy and physiologic functions of the choroid may be affected by obesity, data investigating the effect of obesity on the choroid is limit- ed and/or unavailable for the Saudi population. Objective: To assess Choroidal Thickness (CT) changes in a sample of healthy Saudi Arabian wom- en with different Body Mass Index (BMI) using Spectral-domain Ocular Coherence Tomography (SD-OCT). Methods: A total of 140 healthy women aged 18-29 years (mean age ± standard deviation SD, 24.5 ± 1.7 years) with different BMI, axial length (AL) ≤ 24 ± 1.0 mm, and spherical equivalent refrac- tion (SER) of ≤ ±2.0 dioptres were enrolled for the study. The participants were age and refraction- matched, and grouped into underweight (BMI ≤ 18.0 kg/m2) (n = 30), normal (control group) (18.5–24.9 kg/m2) (n = 43), overweight (25.0–29.9 kg/m2) (n=37), and obese study groups (≥ 30.0 kg/m2) (n = 30). SD-OCT imaging was performed on one eye of each participant. Comparisons among groups for all locations and the associations between CT and other variables were ex- amined. Results: The mean CT at the subfoveal region (285 ± 31 μm, range: 203 μm to 399 μm) was signif- icantly greater, and it was the lowest in the nasal region (248 ± 26 μm, range 154 to 304) compared with other locations, across all the groups (p < 0.05). Compared with the control, the subfoveal choroid was thinner in the obese group (mean difference: 22.6 μm, 95% Confidence Interval; CI: 8.6 μm to 36.6 μm; p = 0.02) and across all locations (p < 0.05) but thicker at the temporal location in the underweight group (12.4 μm, 95% CI: -23.7 μm to -1.04 μm; p = 0.01). No significant asso- ciation of subfoveal CT with any of the measured parameters, including age (p-values ranged from 0.10 to 0.90), was found. Conclusion: BMI may have an influence on the CT of healthy individuals and could be a cofoun- der in research studies on CT. It is, therefore, recommended that BMI should be evaluated in the clinical diagnosis and management of conditions associated with choroid in healthy individuals. Keywords: Obesity, body mass index, choroidal thickness, spectral domain ocular coherence tomography, imaging, clinical di- agnosis. 1. INTRODUCTION Obesity has been reported to be one of the major public health challenges globally, especially among women [1]. *Address correspondence to this author at the Translational Health Re- search Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; Tel: +61 (40)1193 234; E-mail: l.osuagwu@westernsydney.edu.au There has been an increase in the prevalence of obesity worldwide in the past three decades [2, 3], with about 1.9 bil- lion adults reported to be overweight, and approximately 300 million women are now thought to be clinically obese [4, 5]. Saudi Arabian women have one of the highest rates of obesity in the world [6], leading to significant health problems not only for the women but also for families and communities, who have to bear the cost of managing the as- 1875-6603/22 $65.00+.00 © 2022 Bentham Science Publishers Send Orders for Reprints to reprints@benthamscience.net 666 Current Medical Imaging, 2022, 18, 666-673 RESEARCH ARTICLE Choroidal Thickness Measured by Ocular Coherence Tomography (SD-OCT) and Body Mass Index in Healthy Saudi Women: A Cross-sectional Controlled Study