Abstract
Purpose :
To retrospectively assess the progression of non-proliferative Diabetic Retinopathy after bariatric surgery for Diabetes Systemic Control.
Methods :
21 Diabetic Retinopathy patients were included in this research. Of those subjects, 14 were obese.
Laparoscopic sleeve gastrectomy (LSG) was the surgery of choice to control the systemic diabetes in most patients. Only three bariatric patients underwent Roux-en-y gastric by-pass.
The patients were evaluated for Diabetic Retinopathy before the surgery and followed for 2 years, every 3 months.
Results :
We observed differences in non-proliferative diabetic retinopathy response for different techniques in bariatric surgery for systemic diabetes control.
30% of the patients had a good response with control of systemic Diabetes following bariatric surgery
30% had worsening of the initial vision and clear progression of the diabetic retinopathy, evolving to anti-VEGF treatment
40% were initially stable (around 6 months) but showed, subsequently, worsening of the best corrected visual acuity, with progression in diabetic retinopathy ultimately leading to pan retinal photocoagulation plus anti-VEGF IVI.
Conclusions :
It’s impossible to conclude that the bariatric surgery in Systemic Diabetes control has any impact in reducing diabetic retinopathy progression.
The epigenetics factors, also known as metabolic memory, are a very important cause of the permanency of Diabetic Retinopathy is spite of systemic control by surgery.
What this assessment indicated is that it is not possible to predict whether the Diabetic Retinopathy, following glycemic control obtained with bariatric surgery, is going to show signs of progression, regression or stability. Further studies are needed to better clarify our findings.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.