The National Health and Nutrition Examination Survey (NHANES); a population-based survey conducted annually in the US by the Centers for Disease Control and Prevention, was used to identify populations at higher risk for choroidal naevus. Over a period of four years, 5575 subjects aged 40 years or older completed retinal imaging from a 45° non-mydriatic retinal camera; one centred on the macula and the second centred on the optic nerve. Images defined as having a choroidal naevus were based on definitions used in other population-based studies and questionable images for naevus were excluded from analysis. Primary predictors variables used were self-reported weight history. Menopausal status, smoking history and medical history such as hypertension, diabetes and hyperlipidaemia was also self-reported. NHANES from 2005 to 2008 had 4.7% subjects with choroidal naevus on retinal imaging. They were older, more prevalent in Caucasian race, hypertensive, lower in serum HDL and fasting glucose in comparison to subjects without choroidal naevus. The multivariate logistic regression performed with age, sex and race adjusted showed elevated current BMI subjects had a 37% higher odds of choroidal naevus than those with normal current BMI and was replicated in high waist circumference at 41% higher odds. This study describes a relationship between obesity and choroidal naevus in males and females in a large cross-sectional population study. Although much of the data is self-reported with a risk for inaccurate recollection and recall bias as well as a chance for under diagnosis of naevus due to the limited field of retinal image capture, this is an important study which highlights and reiterates the associations between obesity and a potentially cancerous lesion. 

Sex differences in the relationship between obesity and choroidal nevus in US adults.
Sieburth R, Qiu M, Shields C.
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Wai Siene Ng

University Hospital of Wales, Cardiff, UK.

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