Evaluation of the alteration in retinal features following bariatric surgery in patients with morbid obesity

Yıl 2022, Cilt: 5 Sayı: 3, 789 - 793, 30.05.2022

Ferhat Çay , Gozde Sahın Vural

https://doi.org/10.32322/jhsm.1080209

Öz

Aim: The aim of the study is to evaluate the effect of bariatric surgery on the retina and choroid in non-diabetic and non-hypertensive patients with morbid obesity using optic coherence tomography (OCT) retrospectively.
Material and Method: Seventy-four eyes of seventy-four patients who have been underwent sleeve gasterectomy for morbid obesity in Balıkesir University Medicine Faculty & February 2019 and November 2020 were evaluated. All participants has a detailed ophthalmologic examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp biomicroscopy, retinal examination through non-dilated pupil via 90 D fundus lens, the retinal thickness (central, perifoveal, and parafoveal superior/nasal/inferior/temporal quadrants), and choroidal thickness through optic coherence tomography (RTVue XR Avanti, Optovue) in immediate preoperative and postoperative sixth-month. All values were compared.
Results: The macular thickness was increased significantly in all quadrants in postoperative visits (p<0.05). There was no change in choroidal thickness with surgery (p:0.898). The change in BMI was found correlated with the postoperative paranasal macular thickness (R:0.273, p:0.024) and mean macular thickness (R: 0.244, p: 0.045). There was no correlation between preoperative BMI, and preoperative/postoperative macular thickness (p>0.05). The correlation between preoperative BMI and preoperative choroidal thickness was significant (R: 0.416, p<0.05).
Conclusion: In patients with morbid obesity, the retinal thickness increases with an effective BMI change after bariatric surgery while choroidal thickness was not affected. The effective weight loss has a significant effect on retinal structure.

Anahtar Kelimeler

Morbid obesity, Sleeve gastrectomy, Retinal thickness, Choroidal thickness, Optic coherence tomography

Kaynakça

• Dogan B, Erol MK, Dogan U, et al. The retinal nerve fiber layer, choroidal thickness, and central macular thickness in morbid obesity: An evaluation using spectral-domain optical coherence tomography. Eur Rev Med Pharmacol Sci 2016; 20: 886-91.
• Obesity and overweight [Internet]. [cited 2021 Aug 24].
• Grundy SM. Metabolic complications of obesity. Endocrine 2000; 13: 155-65.
• Cheung N, Wong TY. Obesity and eye diseases. Surv Ophthalmol 2007; 52: 180-95.
• Segal JB, Clark JM, Shore AD, et al. Prompt reduction in use of medications for comorbid conditions after bariatric surgery. Obes Surg 2009; 19: 1646-56.
• Chang S, Stoll CRT, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg 2014; 149: 275-87.
• Brynskov T, Laugesen CS, Floyd AK, Sørensen TL. Thickening of inner retinal layers in the parafovea after bariatric surgery in patients with type 2 diabetes. Acta Ophthalmol 2016; 94: 668-74.
• Laiginhas R, Guimarães M, Cardoso P, et al. Bariatric surgery ınduces retinal thickening without affecting the retinal nerve fiber layer ındependent of diabetic status. Obes Surg 2020; 30: 4877-84.
• Gonul S, Yilmaz H, Gedik S, Ozturk BT, Oflaz AB, Sahin M. Evaluation of the choroidal thickness and retinal nerve fiber layer, and visual field in morbid obesity: Does bariatric surgery affect retinal structure and function? Indian J Ophthalmol 2020; 69: 301-6.
• Subramaniam K, Low W-Y, Lau P-C, et al. Eating behaviour predicts weight loss six months after bariatric surgery: a longitudinal study. Nutr 2018; 10: 1616.
• Dogan B, Dogan U, Erol MK, Habibi M, Bulbuller N. Optical coherence tomography parameters in morbidly obese patients who underwent laparoscopic sleeve gastrectomy. J Ophthalmol 2016; 2016.
• Grizelj I, Cavka A, Bian J, et al. Reduced flow-and acetylcholine-induced dilations in visceral compared to subcutaneous adipose arterioles in human morbid obesity. Microcirculation 2015; 22: 44-53.
• Tarzia P, Lanza G, Sestito A, et al. Long-term effects of bariatric surgery on peripheral endothelial function and coronary microvascular function. Obes Res Clin Pract 2017; 11: 114-7.
• Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 2011; 11: 98-107.
• Chawla A, Nguyen KD, Goh YPS. Macrophage-mediated inflammation in metabolic disease. Nat Rev Immunol 2011: 738-49.
• Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011: 85-97.
• Hotamisligil GS, Arner P, Caro JF, Atkinson RL, Spiegelman BM. Increased adipose tissue expression of tumor necrosis factor-α in human obesity and insulin resistance. J Clin Invest 1995; 95: 2409-15.
• Bulus AD, Can ME, Baytaroglu A, Can GD, Cakmak HB, Andiran N. Choroidal thickness in childhood obesity. Ophthalmic Surg Lasers Imaging Retin 2017; 48: 10-7.
• Yumusak E, Ornek K, Durmaz SA, Cifci A, Guler HA, Bacanli Z. Choroidal thickness in obese women. BMC Ophthalmol 2016; 16: 1.
• Stojanov O, Stokic E, Šveljo O, Naumovic N. Uticaj retrobulbarnog masnog tkiva na intraokularni pritisak kod gojaznih osoba. Vojnosanit Pregl 2013; 70: 469-76.
• Panon N, Luangsawang K, Rugaber C, et al. Correlation between body mass index and ocular parameters. Clin Ophthalmol 2019; 13: 755-62.
• Teberik K, Eski MT, Doğan S, Pehlivan M, Kaya M. Ocular abnormalities in morbid obesity. Arq Bras Oftalmol 2019; 82: 6-11.
• Baran R, Baran S, Toraman N, Filiz S, Demirbilek H. Evaluation of intraocular pressure and retinal nerve fiber layer, retinal ganglion cell, central macular thickness, and choroidal thickness using optical coherence tomography in obese children and healthy controls. Niger J Clin Pract 2019; 22: 539-45.
• Tanabe H, Ito Y, Iguchi Y, Ozawa S, Ishikawa K, Terasaki H. Correlation between cross-sectional shape of choroidal veins and choroidal thickness. Jpn J Ophthalmol 2011; 55: 614-9.