Skip to main content
SpringerLink
Log in

Short-Term Impact of Bariatric Surgery on Best-Corrected Distance Visual Acuity and Diabetic Retinopathy Progression

  • Brief Communication
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

The immediate impact of rapid glucose lowering induced by bariatric surgery on diabetic retinopathy (DR) progression remains unclear. We present 3-year changes in the best-corrected visual acuity and DR grade in a retrospective observational study of 32 morbidly obese patients (64 eyes) who underwent Roux-en-Y-gastric bypass surgery. We found that despite overall benefits in vision, there was an initial progression from no retinopathy to background retinopathy in 18.9% and 21.7% at years 1 and 2 respectively. Patients with pre-proliferative DR at baseline were at increased risk of developing sight-threatening DR. We recommend that patients with diabetes undergoing bariatric surgery have a baseline visual acuity, macular optical coherent tomography and diabetic retinopathy grading from wide-field digital imaging to identify those at risk of sight-threatening diabetic retinopathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–256. e5.

    Article  PubMed  Google Scholar 

  2. National Institute For Health and Clinical Excellence (NICE). Obesity: identification, assessment and management (CG189). 2014. Available from https://www.nice.org.uk/guidance/cg189/resources/obesity-identification-assessment-and-management-pdf-35109821097925. Accessed 10 June 2018.

  3. Murphy R, Jiang Y, Booth M, et al. Progression of diabetic retinopathy after bariatric surgery. Diabet Med. 2015;32(9):1212–20.

    Article  CAS  PubMed  Google Scholar 

  4. Merlotti C, Ceriani V, Morabito A, et al. Bariatric surgery and diabetic retinopathy: a systematic review and meta-analysis of controlled clinical studies. Obes Rev. 2017;18:309–16.

    Article  CAS  PubMed  Google Scholar 

  5. Coleman KJ, Haneuse S, Johnson E, et al. Long-term microvascular disease outcomes in patients with type 2 diabetes after bariatric surgery: evidence for the legacy effect of surgery. Diabetes Care. 2016;39:1400–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Feldman-Billard S, Larger É, Massin P, et al. Early worsening of diabetic retinopathy after rapid improvement of blood glucose control in patients with diabetes. Diabetes Metab. 2018;44:4–14.

    Article  CAS  PubMed  Google Scholar 

  7. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44.

    Article  CAS  PubMed  Google Scholar 

  8. Vilsboll T, Bain SC, Leiter LA, et al. Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy. Diabetes Obes Metab. 2018;20:889–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Davis MD, Beck RW, Home PD, et al. Early retinopathy progression in four randomized trials comparing insulin glargine and NPH [corrected] insulin. Exp Clin Endocrinol Diabetes. 2007;115(4):240–3.

    Article  CAS  PubMed  Google Scholar 

  10. Rosenstock J, Fonseca V, McGill JB, et al. Similar progression of diabetic retinopathy with insulin glargine and neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes: a long-term, randomised, open-label study. Diabetologia. 2009;52(9):1778–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Opthalmology, Derby Teaching Hospital NHS Foundation Trust, Derby, UK

    Patrick Richardson & Adela Hulpus

  2. Division of Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK

    Iskandar Idris

  3. Nottingham Biomedical Research Centre, National Institute of Health Research, Nottingham, UK

    Iskandar Idris

  4. Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Uttoxeter Road, Derby, DE22 3DT, UK

    Iskandar Idris

Authors
  1. Patrick Richardson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adela Hulpus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Iskandar Idris
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Iskandar Idris.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Not applicable. This was a retrospective evaluation of routine clinical practice. For this type of study, formal consent is not required.

Human and Animal Rights

This was a retrospective evaluation of routine clinical practice. Data collection was performed in accordance with the ethical standards of the Derby Teaching Hospitals NHS Trust.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Richardson, P., Hulpus, A. & Idris, I. Short-Term Impact of Bariatric Surgery on Best-Corrected Distance Visual Acuity and Diabetic Retinopathy Progression. OBES SURG 28, 3711–3713 (2018). https://doi.org/10.1007/s11695-018-3445-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3445-z

Keywords

Search

Navigation