Does bariatric surgery adversely impact on diabetic retinopathy in persons with morbid obesity and type 2 diabetes? A pilot study

J Diabetes Complications. 2014 Mar-Apr;28(2):191-5. doi: 10.1016/j.jdiacomp.2013.10.006. Epub 2013 Oct 23.

Abstract

Aims: To assess the incidence and progression of diabetic retinopathy (DR) 12 months post bariatric surgery in persons with morbid obesity and type 2 diabetes.

Methods: A retrospective pilot analysis of electronic hospital records between 1998 and 2012.

Results: 40 of 148 subjects had pre- and post-surgery DR screening. Of those without DR pre-surgery 1.5% (n = 26) progressed to minimum background DR (BDR) post surgery. Those with minimum BDR (n = 9) pre-surgery revealed no progression, with 55.6% (n = 5) showing evidence of regression. One person with moderately severe BDR and two with pre-proliferative DR (PPDR) prior to surgery experienced progression. Two persons with PPDR prior to surgery remained under the hospital eye services and were therefore not eligible to be re-assessed by the screening service.

Conclusions: There was a low incidence of new DR and progression of DR in those either without evidence of retinopathy or with minimal BDR prior to surgery with some subjects showing evidence of regression. There was however a risk of progression of DR in those with moderate BDR or worse, and should therefore be monitored closely post-surgery.

Keywords: Bariatric surgery; Diabetic Retinopathy; Obesity; Type 2 diabetes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bariatric Surgery / adverse effects*
  • Bariatric Surgery / statistics & numerical data
  • Child
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / surgery*
  • Diabetic Retinopathy / epidemiology
  • Diabetic Retinopathy / etiology*
  • Disease Progression
  • Humans
  • Middle Aged
  • Obesity, Morbid / complications*
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Pilot Projects
  • Retrospective Studies
  • United Kingdom / epidemiology
  • Wales / epidemiology
  • Young Adult