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Bariatric Surgery Induces Retinal Thickening Without Affecting the Retinal Nerve Fiber Layer Independent of Diabetic Status

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Abstract

Purpose

Obese patients have neurodegeneration of the optic nerve demonstrated by decreased peripapillary nerve fiber layer. Whether bariatric surgery reverses this neurodegenerative process has not been explored. We aimed to evaluate the impact of bariatric surgery in the structure of the retina and optic nerve.

Methods

Multicentric observational study. Obese patients scheduled for bariatric surgery were consecutively recruited and included in the study and evaluated before and 6–12 months after the intervention. The retinal structure was evaluated as retinal thickness in the different retinal layers in the foveal, perifoveal, and parafoveal regions using optical coherence tomography. Choroidal thickness and optic nerve retinal nerve fiber layer thickness were also evaluated.

Results

Eighty eyes from 40 participants were included. Globally, we found a significant thickening of the retina after bariatric surgery (foveal: 273.5 (21.5) μm vs 280.0 (28.8) μm, p < 0.001; parafoveal 332.4 ± 17.8 μm vs 336.6 ± 15.9 μm, p = 0.003; perifoveal: 293.4 ± 13.8 μm vs 295.7 ± 14.9 μm; p = 0.001), whereas no significant differences were found for the ganglion cell layer, choroid, or peripapillary nerve fiber layer thickness. The retinal thickening was confined to inner retinal layers and was independent of the diabetic status of the patients. After multivariate adjustment, HbA1c variation, preoperative C-peptide, preoperative hypertension, preoperative OSA, and preoperative LDL and TG levels seem to be clinical predictors of retinal thickening.

Conclusions

We found a significant thickening of the retina after bariatric surgery that was independent of the diabetic status. The thickening was confined to inner retinal layers and may represent and improve perfusion. The peripapillary nerve fiber layer remained unchanged after the surgery.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector.

Author information

Authors and Affiliations

  1. PDICSS, Faculty of Medicine of Porto University (FMUP), Porto, Portugal

    Rita Laiginhas

  2. Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

    Rita Laiginhas & João Chibante

  3. Department of General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal

    Marta Guimarães & Mário Nora

  4. Unit for Multidisciplinary Research in Biomedicine (UMIB), Endocrine, Cardiovascular and Metabolic Research, University of Porto, Porto, Portugal

    Marta Guimarães & Mário Nora

  5. Department of Anatomy, Institute of Biomedical Science Abel Salazar (ICBAS), University of Porto, Porto, Portugal

    Marta Guimarães

  6. Department of Ophthalmology, Centro Hospitalar e Universitário São João, Porto, Portugal

    Pedro Cardoso, Fernando Falcão-Reis & Manuel Falcão

  7. Department of Surgery, Centro Hospitalar e Universitário São João, Porto, Portugal

    Hugo Santos-Sousa & John Preto

  8. Department of Surgery, Faculty of Medicine of Porto University (FMUP), 4200-319, Porto, Portugal

    Hugo Santos-Sousa & John Preto

  9. Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), 4200-319, Porto, Portugal

    Fernando Falcão-Reis & Manuel Falcão

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  1. Rita Laiginhas
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Correspondence to Manuel Falcão.

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Laiginhas, R., Guimarães, M., Cardoso, P. et al. Bariatric Surgery Induces Retinal Thickening Without Affecting the Retinal Nerve Fiber Layer Independent of Diabetic Status. OBES SURG 30, 4877–4884 (2020). https://doi.org/10.1007/s11695-020-04904-7

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  • DOI: https://doi.org/10.1007/s11695-020-04904-7

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