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Tamara Vrabec, Tatiana Franco, Christopher Still, Craig Wood, Vincent Baldassano; Retinal Vaculopathy in the Morbidly Obsese. Invest. Ophthalmol. Vis. Sci. 2013;54(15):192.
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The prevalence of retinal vasculopathy in diabetic and non-diabetic persons with increased BMI has been described. The purpose of this investigation was to describe the prevalence and spectrum of retinal vasculopathy in morbidly obese and to determine if diabetes or BMI is associated with prevalence of retinopathy.
One hundred morbidly obese patients (BMI>40 kg/m2 or BMI>35 kg/m2 with significant co-morbidity) were recruited into this prospective study. Clinical data included age, gender, presence and duration of diabetes, BMI, and dilated fundus photography. Microvascular retinopathy was graded by two independent observers using the Early Treatment Diabetic Retinopathy Study (ETDRS) retinopathy grades. Arterial-venule ratio (AVR) was used to evaluate macrovascular retinopathy and calculated using Knudtson’s revised formulas. Prevalence of microvascular retinopathy (and 95% confidence intervals) was calculated for those with and without diabetes. Mean AVR was calculated for the entire population, was compared between patients with and without diabetes, and was correlated with BMI using Pearson correlation.
Patients included 30 males and 70 females with a mean age of 49 years (range=[25, 71]). Forty-five (45%) of the patients were diabetic with a duration of diabetes ranging from 1 month to 30 years (mean=8 years). BMI ranged from 35 kg/m2 to 97 kg/m2 with a mean of 48.5 kg/m2 (SD=9.3). Microvascular retinopathy was present in 17 of 45 diabetics (37.8%, 95% CI=[23.8%, 53.5%]) and in 2 of 55 non-diabetics (3.6%, 95% CI=[0.1%, 11.8%]). ETDRS grades in affected patients ranged from 3 to 35. The mean AVR for the 100 patients was 0.664 (95% CI=[0.654, 0.674]). Mean AVR was not significantly different between patients with and without diabetes (diabetes mean=0.670, no diabetes mean = 0.659, two-sample t-test p-value = 0.290). AVR was not significantly correlated with BMI (r = -0.02, p-value=0.830).
The prevalence of retinal vasculopathy, which in this population included only non-proliferative diabetic, is greater in morbidly obese diabetics than non-diabetics, and exceeds those reported for obese diabetics with lower BMI. BMI was not correlated with AVR.
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