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

• Published in: Journal of diabetes and its complications Vol. 28; no. 2; pp. 191 - 195
• Main Authors: Thomas, Rebecca L, Prior, Sarah L, Barry, Jonathan D, Luzio, Stephen D, Eyre, Nia, Caplin, Scott, Stephens, Jeffrey W, Owens, David R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2014; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bariatric surgery; Bariatric Surgery - adverse effects; Bariatric Surgery - statistics & numerical data; Child; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - surgery; Diabetic Retinopathy; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - etiology; Disease Progression; Endocrinology & Metabolism; Gastrointestinal surgery; Humans; Middle Aged; Obesity; Obesity, Morbid - complications; Obesity, Morbid - epidemiology; Obesity, Morbid - surgery; Pilot Projects; Retrospective Studies; Type 2 diabetes; United Kingdom - epidemiology; Wales - epidemiology; Weight control; Young Adult; United Kingdom > UK; Wales; Type 2 diabetes; Obesity; Bariatric surgery; Diabetic Retinopathy
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2013.10.006

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.