Abstract
Purpose :
The objective of this study was to assess the prevalence of papilledema in morbidly obese Korean patients with lower body mass index (BMI) before bariatric surgery in accordance with IFSO-APC Consensus Statement and evaluate visual impairments such as visual loss, visual field defect, and retinal nerve fiber layer (RNFL) thickness change after bariatric surgery.
Methods :
A prospective, uncontrolled study was conducted with 24 consecutive patients undergoing bariatric surgery for morbid obesity. All subjects were evaluated for their pre-operative height, weight, and body mass index. They were asked to complete a questionnaire regarding possible signs of idiopathic intracranial hypertension (IIH). Visual acuity, intraocular pressure (IOP), fundus stereoscopic photography was measured, and RNFL thickness around optic disc was evaluated using Optical Coherence Tomography (OCT). Automated perimetry was conducted using Humphrey® visual field analyzer. All data were assessed at baseline, 3 months, and 6 months postoperatively.
Results :
No patient showed optic disc papilledema except one when assessing preoperative optic disc evaluation. Vision-threatening changes of symptom and sign were not found after surgery during the observation period. The overall RNFL thickness(Baseline : 100.08 ± 11.50 µm (OD), 100.69 ± 11.43 µm (OS)) around the optic disc was slightly decreased at 3 months (98.96 ± 13.17 µm (OD), 99.04 ± 14.06 µm (OS)) after surgery and then slightly increased at 6 months (100.23 ± 11.65 µm (OD), 100.85 ± 11.63 µm (OS)) which was well above preoperative level. The result of visual field MD (Baseline : - 3.59 ± 1.63 dB (OD), - 4.09 ± 2.35 dB (OS)) was nearly unchanged (- 3.54 ± 1.89 dB (OD), - 4.34 ± 1.56 dB (OS) at 3 months; - 3.59 ± 1.84 dB (OD), - 4.55 ± 1.62 dB (OS) at 6 months). All these changes were statistically insignificant.
Conclusions :
The percentage of optic papilledema in morbidly obese Korean patients with lower BMI was lesser than those reported elsewhere. Anatomical and functional changes of optic disc were very little, which means it was unnecessary to have detailed eye examination routinely.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.