Abstract
Introduction Being underweight (body-mass index < 18.50 kg/m(2)) is associated with significantly higher morbidity than having normal weight. We aimed to investigate the changes in choroid and retinal capillary microcirculation with optical coherence tomography angiography in underweight female subjects compared with an age- and sex-matched population of healthy subjects. Methods This prospective, cross-sectional study included 48 eyes of 48 healthy female subjects, of whom 23 were underweight and 25 had normal weight. Optical coherence tomography angiography was used for the evaluation of retinal vessel density, foveal avascular zone, subfoveal central macular thickness, subfoveal choroidal thickness, and choriocapillaris flow area. Results The mean choriocapillaris flow area was statistically significantly higher in the underweight group (2.201 ± 0.11 mm(2)) compared to the control group (2.111 ± 0.11 mm(2)) (p=0.005). The subfoveal choroidal thickness was higher in the underweight group (340 ± 61.2 µm) compared to the control group (317 ± 20.8 µm) but the difference was not statistically significant (p=0.099). Similarly, no statistically significant difference was determined between the groups concerning the vessel density, subfoveal central macular thickness, and foveal avascular zone. Conclusions Being underweight is associated with a higher subfoveal choroidal thickness and choriocapillaris flow area, independent of additional factors, such as age, axial length, intraocular pressure, and major ocular diseases.