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Bariatric Surgery

Effects of bariatric surgery on retinal microvascular architecture in obese patients

International Journal of Obesity volume 43, pages 1675–1680 (2019)Cite this article

Subjects

Abstract

Study aim

Retinal microvasculature changes reflect systemic small vessel damage from obesity. The impact of bariatric surgery induced weight loss on the microvasculature is relatively unknown. We hypothesized that weight loss following bariatric surgery would be associated with improved structural changes in the retinal microvasculature, reflecting an overall improvement in microvascular health.

Methods

The study included 22 obese subjects scheduled for bariatric surgery (laparoscopic Roux-en-Y gastric bypass or a sleeve gastrectomy) and 15 lean, age-matched controls. Ophthalmic examination, including fundus photography, was performed at baseline and 6-months. Retinal microvasculature caliber was analysed quantitatively using a semi-automated computer program and summarized as central retinal artery equivalent (CRAE) and venular equivalent (CRVE).

Results

Mean weight loss at 6 months was 26.1 kg ± 8 kg in the bariatric surgery group. Retinal artery caliber increased (136.0 ± 1.4 to 141.4 ± 1.4 µm, p = 0.013) and venular caliber decreased (202.9 ± 1.9 to 197.3 ± 1.9 µm, p = 0.046) in the bariatric surgery group by 6 months, with no change in arteriolar (136.6 ± 1.1 to 134.5 ± 1.2, p = 0.222) or venular (195.1 ± 2.1 to 193.3 ± 2.2, p = 0.550) caliber in the control group. The arteriolar to venular ratio increased in the bariatric surgery group, with no change in the control group at 6 months.

Conclusions

The findings suggest obesity-related microvascular changes are reversible after bariatric surgery-induced weight loss. The capacity for the retinal microvasculature to improve following bariatric surgery suggests plasticity of the human microvasculature early in the disease course.

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Acknowledgements

This study was conducted within the Finnish Centre of Excellence in Cardiovascular and Metabolic Diseases supported by the Academy of Finland, the University of Turku, the Turku University Hospital, the Åbo Academy University, and the Finnish Eye Foundation.

Author information

Authors and Affiliations

  1. Medilaser Turku, Cor Group, Turku, Finland

    Antti Viljanen

  2. Department of Ophthalmology, University of Turku and Turku University Hospital, Turku, Finland

    Antti Viljanen & Eija Vesti

  3. Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland

    Antti Viljanen, Henry K. Karlsson & Pirjo Nuutila

  4. Department of Endocrinology, Turku University Hospital, Turku, Finland

    Minna Soinio & Pirjo Nuutila

  5. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong

    Carol Yim-lui Cheung

  6. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore

    Carol Yim-lui Cheung & Tien Yin Wong

  7. Turku PET Centre, University of Turku, Turku, Finland

    Jarna C. Hannukainen

  8. Office of Academic and Clinical Development, Duke-NUS Medical School, National University of, Singapore, Singapore

    Tien Yin Wong

  9. Institute of Cardiovascular Science, University College London, London, UK

    Alun D. Hughes

  10. Department of Surgery, University of Turku, and Turku University Hospital, Turku, Finland

    Paulina Salminen

  11. Population Health Research Institute, St Georges, University of London, London, UK

    Robyn J. Tapp

  12. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia

    Robyn J. Tapp

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  1. Antti Viljanen
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Corresponding author

Correspondence to Robyn J. Tapp.

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Conflict of interest

We declare that we have no conflicts of interest. This study was conducted within the Finnish Centre of Excellence in Cardiovascular and Metabolic Diseases supported by the Academy of Finland, the University of Turku, the Turku University Hospital, the Åbo Academy University, and the Finnish Eye Foundation. This study was registered at ClinicalTrials.gov under registration number NCT01373892.

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Synopsis

Bariatric surgery led to a reduction in retinal arteriolar narrowing and venular widening, with no changes observed in the control group. These findings are consistent with the observed cardiovascular risk reduction post bariatric surgery.

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Viljanen, A., Soinio, M., Cheung, C.Yl. et al. Effects of bariatric surgery on retinal microvascular architecture in obese patients. Int J Obes 43, 1675–1680 (2019). https://doi.org/10.1038/s41366-018-0242-7

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  • DOI: https://doi.org/10.1038/s41366-018-0242-7

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