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病态肥胖患者脉络膜厚度、视网膜神经纤维层和视野评估:减重手术是否会影响视网膜结构和功能?

Evaluation of the choroidal thickness and retinal nerve fiber layer and visual fields in morbid obesity: Does bariatric surgery affect retinal structure and function?

机构信息

Department of Ophtalmology, Selcuk University Faculty of Medicine, Konya, Turkey.

Department of General Surgery, Selcuk University Faculty of Medicine, Konya, Turkey.

出版信息

Indian J Ophthalmol. 2021 Feb;69(2):301-306. doi: 10.4103/ijo.IJO_295_20.

Abstract

PURPOSE

The study aimed to investigate the changes in choroidal thickness (CT), retinal nerve fiber layer thickness (RNFL), and visual field parameters in morbidly obese patients following bariatric surgery.

METHODS

The study included 40 morbidly obese patients with body mass indexes (BMI) ≥40 who had undergone bariatric surgery (Group 1) and 40 age-and sex-matched healthy subjects with normal BMI values (Group 2). RNFL and CT measurements by optical coherence tomography (OCT) and visual field test were performed preoperatively and the 1, 6, and 12th months postoperatively. CT measurements were obtained from the subfoveal, nasal (N), and temporal (T) regions at distances of 500 μm and 1,000 μm from the fovea.

RESULTS

No significant pathology was detected during ophthalmological examinations following bariatric surgery. The BMIs were found to be significantly lower in all of the periods after bariatric surgery (P < 0.0001). The CT measurements decreased significantly in all periods after bariatric surgery (P < 0.0001). No differences were found in terms of the mean RNFL thicknesses in all postoperative periods (P = 0.125). Visual field tests showed no significant changes during scheduled visits. (P = 0.877). No visual field defect was detected in any patient during the follow-up periods after bariatric surgery.

CONCLUSION

These results have suggested that CT is positively correlated with BMI and decreased with a reduction in BMI progressively. Nutritional disorders resulting from malabsorption have not caused any nutritional optic neuropathy and visual field defect for at least the first postoperative year after bariatric surgery.

摘要

目的

本研究旨在探讨减重手术后病态肥胖患者脉络膜厚度(CT)、视网膜神经纤维层厚度(RNFL)和视野参数的变化。

方法

本研究纳入了 40 名 BMI≥40 的病态肥胖患者(组 1)和 40 名年龄和性别匹配的 BMI 正常的健康受试者(组 2)。所有患者均行光学相干断层扫描(OCT)和视野检查,分别于术前及术后 1、6 和 12 个月测量 RNFL 和 CT。CT 测量在距黄斑中心凹 500μm 和 1000μm 处的黄斑下、鼻侧(N)和颞侧(T)区域进行。

结果

减重手术后的眼科检查未发现明显病变。所有减重手术后各时间段的 BMI 均显著降低(P<0.0001)。减重手术后所有时间段的 CT 测量值均显著降低(P<0.0001)。所有术后时间段的平均 RNFL 厚度均无差异(P=0.125)。视野检查在预定随访期间未发现明显变化(P=0.877)。减重手术后随访期间,未发现任何患者出现视野缺损。

结论

这些结果表明,CT 与 BMI 呈正相关,且随 BMI 的降低而逐渐降低。吸收不良引起的营养障碍在减重手术后至少 1 年内并未导致任何营养性视神经病变和视野缺损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/373c/7933847/44388b559ab5/IJO-69-301-g001.jpg

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