Abstract
PurposeThe aim of this study was to investigate the pathogenic role of obesity on blinding eye diseases in a population of severely obese patients with no history of eye diseases, and to verify whether weight loss induced by bariatric surgery may have a protective effect.MethodsThis was a pilot, monocentric, prospective, and open label study conducted at the University Hospital of Pisa. Fifty-seven severely obese patients with a mean body mass index value of 44.1 ± 6 kg/m2 were consecutively recruited and received a complete ophthalmological evaluation and optical coherence tomography. Twenty-nine patients who underwent gastric bypass were evaluated also 3 months, and 1 year after surgery.ResultsAt baseline, blood pressure value were directly and significantly related to intraocular pressure values (p<0.05, R = 0.35). Blood pressure values were also significantly and inversely related to retinal nerve fiber layer thickness, particularly in the temporal sector (RE p<0.05 r-0.30; LE p<0.01, R = -0.43). Moreover, minimum foveal thickness values were significantly and inversely associated with body mass index (RE p<0.02, R = -0.40; LE p<0.02, R = -0.30). A significant reduction of body mass index (p<0.05) and a significant (p<0.05) improvement of blood pressure was observed three months and one year after gastric bypass, which were significantly associated with an increase in retinal nerve fiber layer thickness and minimum foveal thickness values in both eyes (p<0.05).ConclusionsThe results of this study suggest that obese patients may have a greater susceptibility to develop glaucomatous optic nerve head damage and age-related macular degeneration. Moreover, weight reduction and improvement of comorbidities obtained by bariatric surgery may be effective in preventing eye disease development by improving retinal nerve fiber layer and foveal thickness.
Highlights
Obesity is a major public health problem, due to its increasing prevalence in most countries and the related health risks
A significant reduction of body mass index (p
The results of this study suggest that obese patients may have a greater susceptibility to develop glaucomatous optic nerve head damage and age-related macular degeneration
Summary
Obesity is a major public health problem, due to its increasing prevalence in most countries and the related health risks. Obesity and obesity-related systemic diseases determine a greater risk for blinding eye diseases, such as cataract, glaucoma and age-related macular degeneration (AMD) [2]. Bariatric surgery is currently the most effective mean to reach a substantial and stable body weight reduction in severe morbid obesity, with an important amelioration of various comorbidities [3]. The association between vitamin deficiencies after bariatric surgery and related eye diseases is well established [6]. Little is known about the effects of bariatric surgery on eye diseases of different aetiologies. In this study we measured several ophthalmologic parameters in a population of severely obese patients with no history of eye diseases, to get further insights into the pathogenic role of obesity on blinding eye diseases and to verify whether weight loss induced by bariatric surgery may have a protective effect
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