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Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study

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Abstract

Purpose

Obesity is associated with increased cardiovascular risk. Bariatric surgery (BS) improves the clinical and metabolic profile. Retinal caliber changes could precede cardiovascular events. Different studies have shown an improvement in retinal caliber after BS. The aim of this study was to examine retinal caliber and other cardiovascular target organ damage before and after BS.

Materials and Methods

Monocentric, prospective cohort study at the Montpellier University Hospital. Biologic features, vessel stiffness, echocardiograph variables, and retinal caliber at baseline and 6 and 12 months were assessed in consecutive patients with class 2 or 3 obesity undergoing BS. A mixed linear model adjusted for age and sex was used.

Results

We included 88 patients (75 women). The mean (SD) age was 43 years (11) and mean (SD) baseline weight 117 (21) Kg. Mean changes in the first year after BS were − 5.1 µm in central retinal vein equivalent (CRVE) (p < 0.0001), + 0.02 in arteriole-to-venule ratio (AVR) (p < 0.0001), − 1.4 mmol/L in glycemia (p < 0.0001), − 1.0 mg/L in natural logarithm of C-reactive protein (p < 0.0001), and − 54.0 g in left ventricular mass (p = 0.0005). We observed no significant improvement in arterial stiffness markers. Predictors of improvement in CRVE were high baseline weight (p = 0.030), male sex (p = 0.025), and no diabetes history (p Dynamic links between variations

= 0.047).

Conclusion

The retinal microvascular phenotype improved during the first year after bariatric surgery, with decreased CRVE and increased AVR. Factors associated with retinal microvascular plasticity were male sex, high baseline weight, and absence of diabetes. Longitudinal assessment of retinal vascular calibers may offer new insights into the pathophysiology of subclinical vascular processes.

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Funding

The university scholarship “année recherche” from Montpellier University. The sponsors or funding organization had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France

    Eloi Debourdeau, Gabriel Gardes, Max Villain & Vincent Daien

  2. Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France

    Eloi Debourdeau, Isabelle Carriere & Vincent Daien

  3. Digestive Surgery Division A, CHU de Montpellier, F-34000, Montpellier, France

    David Nocca

  4. Department of Ophthalmology, Grenoble Alpes University Hospital, 38048, Grenoble, France

    Christophe Chiquet

  5. Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France

    Camille Roubille, Guilhem Du Cailar, Mathieu Sardinoux & Pierre Fesler

  6. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34000, Montpellier, France

    Camille Roubille & Pierre Fesler

  7. The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, 2000, Australia

    Vincent Daien

Authors
  1. Eloi Debourdeau
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  2. Gabriel Gardes
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  3. David Nocca
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  4. Isabelle Carriere
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  5. Christophe Chiquet
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  6. Max Villain
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  9. Mathieu Sardinoux
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  10. Vincent Daien
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  11. Pierre Fesler
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Corresponding author

Correspondence to Eloi Debourdeau.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Key points

• The retinal microvascular phenotype improved during the first year after bariatric surgery, with decreased central retinal vein equivalent (− 5.1 µm, p < 0.0001), and increased arteriole-to-venule ratio (+ 0.02, p < 0.0001).

• Factors associated with retinal microvascular plasticity were male sex, high baseline weight, and absence of diabetes.

• Longitudinal assessment of retinal vascular calibers may offer new insights into the pathophysiology of subclinical vascular processes.

Electronic supplementary material

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Supplementary file1 (DOCX 18 KB)

Appendices

Appendix

Table 5

Table 5 Previous prospective studies evaluating CRVE CRAE AVR before and after bariatric surgery (all monocentric)
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Appendix 2

Figure 

Fig. 3
figure 3

Correlation between change in clinical-biological variables and change in retinal parameters. Abbreviations: AVR, arteriole-to-venule ratio; CRVE, central retinal vein equivalent; CRAE, central retinal arteriolar equivalent

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Debourdeau, E., Gardes, G., Nocca, D. et al. Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study. OBES SURG 32, 1–10 (2022). https://doi.org/10.1007/s11695-022-06064-2

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  • DOI: https://doi.org/10.1007/s11695-022-06064-2

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