Abstract
Purpose:
To assess the changes in diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients after bariatric surgery.
Methods:
Consecutive twenty patients with T2DM who underwent bariatric surgery and were followed for at least 12 months were enrolled. The case history was reviewed retrospectively, and laboratory data were assessed at baseline and every 3 months postoperatively. Two retinal specialists evaluated the severity of DR with dilated fundus examination pre- and postoperatively. Factors associated with DR progression were assessed
Results:
During the follow-up period, 2 of 12 patients without DR and 2 of 3 patients with mild non-proliferative DR (NPDR) prior to surgery developed moderate NPDR. All five patients with moderate NPDR or worse preoperatively had progression requiring intervention. Pre-existing DR (P = 0.005) and albuminuria (P = 0.01) were identified as associated with DR progression. Six patients (30%) entered remission of T2DM, but remission of T2DM could not halt the DR progression.
Conclusions:
DR progression can occur in patients with or without prior DR after bariatric surgery, regardless of remission of T2DM. All patients with T2DM should be examined regularly by an ophthalmologist postoperatively, and more carefully in patients with prior DR or albuminuria.